| S.t.e.p's Developmental Academy, Inc. | |
|
1516b Alleghany St Charlotte NC 28208-0801 | |
| (980) 207-1819 | |
| (980) 207-1832 |
| Full Name | S.t.e.p's Developmental Academy, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1516b Alleghany St, Charlotte, North Carolina |
| Authorized Official Name and Position | James Weldon Johnson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7048829553 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| S.t.e.p's Developmental Academy, Inc. Po Box 2007 Indian Trail NC 28079-2007 Ph: (704) 532-5757 | S.t.e.p's Developmental Academy, Inc. 1516b Alleghany St Charlotte NC 28208-0801 Ph: (980) 207-1819 |
| NPI Number | 1437284494 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 03/19/2018 |
| Medicare PECOS PAC ID | 0345401816 |
|---|---|
| Medicare Enrollment ID | O20120410000025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437284494 | NPI | - | NPPES |
| 3409568 | Medicaid | NC | |
| 8301170 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Helen B Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679580278 PECOS PAC ID: 7618916149 Enrollment ID: I20050425001216 |
| Provider Name | Keba Bosley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649726589 PECOS PAC ID: 7012256068 Enrollment ID: I20200108001215 |
| Provider Name | Terri Ellerbe-graves |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356748651 PECOS PAC ID: 4688018948 Enrollment ID: I20240215000408 |
| Provider Name | Nadine Roberts |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205056454 PECOS PAC ID: 1254776974 Enrollment ID: I20240304001447 |
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