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General NPI Number Information
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NPI Number | 1144045279
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Entity Type | Organization
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Legal Business Name | GEARS OF CHANGE LLC
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 4156 SORENSTEN DR
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City | AIKEN
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State | SC
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Zip | 29803-5169
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Country | US
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Telephone | 803-716-8442
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Fax |
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Provider Business Mailing Address
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Address Line | 6650 RIVER AVE STE 105 PMB 188643
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ASHAAD HIPPS
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Credential | DSW, LISW-CP
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Telephone | 803-716-8442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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