=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235673815
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHANGING ATTITUDES TRANSFORMATIONAL COUNSELING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/15/2016
-----------------------------------------------------
Last Update Date | 12/15/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1213 MICHIGAN AVE
-----------------------------------------------------
City | ALAMOGORDO
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88310-6725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 575-430-4804
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 148
-----------------------------------------------------
City | LA LUZ
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88337-0148
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | SHIELA WEEHUNT
-----------------------------------------------------
Credential | LPCC
-----------------------------------------------------
Telephone | 575-430-4804
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------