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General NPI Number Information
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NPI Number | 1235951450
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Entity Type | Organization
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Legal Business Name | COUNSELING & CONSULTING FOR MEANINGFUL CHANGE, LLC
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 110 VISTA CENTRE DR STE 18
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City | FOREST
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State | VA
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Zip | 24551-2785
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Country | US
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Telephone | 434-316-6025
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Fax |
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Provider Business Mailing Address
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Address Line | 1107 COTTONTOWN MANOR DR APT 302
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City | FOREST
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State | VA
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Zip | 24551-2539
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Country | US
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Telephone | 434-238-7709
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATELYN CHILDS
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Credential | LPC
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Telephone | 434-316-6025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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