Provider Demographics
NPI:1902233794
Name:STEPPING FORWARD LLC
Entity Type:Organization
Organization Name:STEPPING FORWARD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSDALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-546-0002
Mailing Address - Street 1:208 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29624-1600
Mailing Address - Country:US
Mailing Address - Phone:864-367-0949
Mailing Address - Fax:866-448-9303
Practice Address - Street 1:512 PROFESSIONAL PARK RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:SC
Practice Address - Zip Code:29325-7627
Practice Address - Country:US
Practice Address - Phone:864-367-0949
Practice Address - Fax:866-448-9303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-11
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty