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General NPI Number Information
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NPI Number | 1053101360
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Entity Type | Organization
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Legal Business Name | CHANGING SEASONS OF NC LLC
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 501 CEDARBROOK RD
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City | JONESVILLE
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State | NC
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Zip | 28642-2413
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Country | US
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Telephone | 828-767-0811
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Fax | 888-870-0545
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Provider Business Mailing Address
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Address Line | PO BOX 625
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City | JONESVILLE
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State | NC
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Zip | 28642-0625
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Country | US
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Telephone | 336-530-0577
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Fax | 888-870-0545
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | WANDA JEAN BURGER
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Credential | LCMHCS CCS MAC CCMC
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Telephone | 828-767-0811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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