Provider Demographics
NPI:1023441144
Name:STEP BY STEP THERAPY, LLC
Entity type:Organization
Organization Name:STEP BY STEP THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:202-489-7260
Mailing Address - Street 1:2321 1ST ST NW
Mailing Address - Street 2:BASEMENT
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1017
Mailing Address - Country:US
Mailing Address - Phone:202-489-7260
Mailing Address - Fax:240-542-4033
Practice Address - Street 1:2321 1ST ST NW
Practice Address - Street 2:BASEMENT
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-1017
Practice Address - Country:US
Practice Address - Phone:202-489-7260
Practice Address - Fax:240-542-4033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC2669225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC071858700Medicaid