Healthcare Provider Details

I. General information

NPI: 1124981311
Provider Name (Legal Business Name): ANCHOR FOR CHANGE GLOBAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 BEACON DR
SUMTER SC
29154-8063
US

IV. Provider business mailing address

759 WHITE BLOSSOM CT
POWDER SPRINGS GA
30127-6416
US

V. Phone/Fax

Practice location:
  • Phone: 803-413-3622
  • Fax:
Mailing address:
  • Phone: 803-413-3622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. LINDA WICKENX
Title or Position: FOUNDER/CEO
Credential: DSW,MSW,LISWCP
Phone: 803-413-3623