# LIFESTEPS, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790982205
- **Authorized official:** MRS. TAY ANGELL NIELSEN LCSW (VICE-PRESIDENT)
- **Authorized official phone:** (601) 750-7759

## Contact information

- **Practice address:** 559 CLUBHOUSE DR, PEARL, MS 39208-9506
- **Practice address phone:** (601) 750-7759
- **Mailing address:** 559 CLUBHOUSE DR, PEARL, MS 39208-9506
- **Mailing address phone:** (601) 750-7759

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | C5559 | MS | Yes |

## Other

- **Enumeration date:** 06/28/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 03558254 | — | MS |