Healthcare Provider Details

I. General information

NPI: 1861694572
Provider Name (Legal Business Name): GLOBAL CHANGE MANAGEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 LEE RD STE 305
WINTER PARK FL
32789-2115
US

IV. Provider business mailing address

1850 LEE RD STE 305
WINTER PARK FL
32789-2115
US

V. Phone/Fax

Practice location:
  • Phone: 407-975-0416
  • Fax:
Mailing address:
  • Phone: 407-975-0416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW0003499
License Number StateFL

VIII. Authorized Official

Name: MS. BARBARA W JORDAN
Title or Position: OWNER
Credential: LCSW
Phone: 407-975-0416