=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194867994
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHANGING DIRECTIONS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2007
-----------------------------------------------------
Last Update Date | 01/31/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CLIENTS' HOME ( IN HOME COUNSELING 509 FAIR OAKS DR
-----------------------------------------------------
City | FAIRFIELD
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35064-2422
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-492-2514
-----------------------------------------------------
Fax | 205-923-2549
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 509 FAIR OAKS DR
-----------------------------------------------------
City | FAIRFIELD
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35064-2422
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-492-2514
-----------------------------------------------------
Fax | 205-923-2549
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT (OWNER)
-----------------------------------------------------
Name | MS. JESSIE LYNNETTA MORRISON
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 205-492-2514
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 257
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------