Basic Information
| Provider Information | |||||||||
| NPI: | 1730796533 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GOLDEN STEPS ABA MD LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 3RD AVE FL 2 | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100161919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6468736600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6700 ALEXANDER BELL DR | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210462122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6155709959 | ||||||||
| FaxNumber: | 6468941116 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2020 | ||||||||
| LastUpdateDate: | 06/24/2022 | ||||||||
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| AuthorizedOfficialLastName: | ROSS | ||||||||
| AuthorizedOfficialFirstName: | REBECCA | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | CREDENTIALING | ||||||||
| AuthorizedOfficialTelephone: | 6155709959 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | N | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst | 103T00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.