Healthcare Provider Details

I. General information

NPI: 1851053508
Provider Name (Legal Business Name): KEY 4 CHANGES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2021
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 LUTHERAN RD
GUYTON GA
31312-5451
US

IV. Provider business mailing address

101 LUTHERAN RD
GUYTON GA
31312-5451
US

V. Phone/Fax

Practice location:
  • Phone: 912-504-0866
  • Fax:
Mailing address:
  • Phone: 912-504-0866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HARLEY STRICKLAND
Title or Position: OWNER
Credential:
Phone: 912-312-3136