Provider Demographics
NPI:1366274797
Name:SMALL STEP, INC
Entity type:Organization
Organization Name:SMALL STEP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MEANEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:520-240-7398
Mailing Address - Street 1:682 LIVE OAK AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4850
Mailing Address - Country:US
Mailing Address - Phone:520-240-7398
Mailing Address - Fax:
Practice Address - Street 1:2335 E EDISON ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-3807
Practice Address - Country:US
Practice Address - Phone:520-240-7398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-15
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty