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General NPI Number Information
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NPI Number | 1124651609
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Entity Type | Organization
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Legal Business Name | HIGHERCHANGE, LLC
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Dates
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Enumeration Date | 02/12/2020
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Last Update Date | 02/13/2020
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Provider Practice Location Address
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Address Line | 7201 WISCONSIN AVE STE 440
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City | BETHESDA
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State | MD
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Zip | 20814-4851
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Country | US
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Telephone | 240-342-6338
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Fax |
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Provider Business Mailing Address
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Address Line | 2211 AVENTURINE WAY
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City | SILVER SPRING
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State | MD
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Zip | 20904-5253
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Country | US
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Telephone | 909-907-2256
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS LUTTRELL
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Credential | LCMFT
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Telephone | 240-342-6338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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