Provider Demographics
NPI:1770982035
Name:STEPPING STONES TO SUCCESS, LLC
Entity type:Organization
Organization Name:STEPPING STONES TO SUCCESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANI
Authorized Official - Middle Name:
Authorized Official - Last Name:MONROE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:404-245-6457
Mailing Address - Street 1:4315 PALISADES PLACE DR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-6146
Mailing Address - Country:US
Mailing Address - Phone:404-245-6457
Mailing Address - Fax:855-204-3767
Practice Address - Street 1:4153 FLAT SHOALS PKWY
Practice Address - Street 2:BUILDING C. SUITE 300 A
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-4106
Practice Address - Country:US
Practice Address - Phone:404-244-9477
Practice Address - Fax:855-204-3767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007586235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003110609AMedicaid