Provider Demographics
| NPI: | 1831420033 |
|---|---|
| Name: | FIRST STEP THERAPY, LLC |
| Entity type: | Organization |
| Organization Name: | FIRST STEP THERAPY, LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | COO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | FEDERICO |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | NICHOLAS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 407-530-5063 |
| Mailing Address - Street 1: | 1650 SAND LAKE RD STE 230 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | ORLANDO |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 32809-9138 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 407-530-5063 |
| Mailing Address - Fax: | 877-399-5578 |
| Practice Address - Street 1: | 1200 N CENTRAL AVE |
| Practice Address - Street 2: | |
| Practice Address - City: | KISSIMMEE |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 34741-4450 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 407-530-5063 |
| Practice Address - Fax: | 877-399-5578 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2010-01-27 |
| Last Update Date: | 2023-07-25 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| 103K00000X, 106E00000X, 106S00000X, 208100000X, 2081P0010X, 225100000X, 225X00000X, 235Z00000X, 251S00000X, 261QM1300X, 261Q00000X | ||
| FL | PT22445 | 252Y00000X |
| FL | 3747P1801X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | Group - Multi-Specialty | |
| No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty | |
| No | 106E00000X | Behavioral Health & Social Service Providers | Assistant Behavior Analyst | Group - Multi-Specialty | |
| No | 106S00000X | Behavioral Health & Social Service Providers | Behavior Technician | Group - Multi-Specialty | |
| No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
| No | 2081P0010X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pediatric Rehabilitation Medicine | Group - Multi-Specialty |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
| No | 251S00000X | Agencies | Community/Behavioral Health | Group - Multi-Specialty | |
| No | 252Y00000X | Agencies | Early Intervention Provider Agency | Group - Multi-Specialty | |
| No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | Group - Multi-Specialty |
| No | 3747P1801X | Nursing Service Related Providers | Technician | Personal Care Attendant | Group - Multi-Specialty |