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General NPI Number Information
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NPI Number | 1750042263
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Entity Type | Organization
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Legal Business Name | CHANGING MINDSETS LTD COMPANY
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Dates
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Enumeration Date | 01/06/2022
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Last Update Date | 08/13/2023
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Provider Practice Location Address
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Address Line | 7700 CROSS RD
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City | PINE BLUFF
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State | AR
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Zip | 71603-9151
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Country | US
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Telephone | 870-723-1703
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Fax |
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Provider Business Mailing Address
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Address Line | 7700 CROSS RD
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City | PINE BLUFF
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State | AR
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Zip | 71603-9151
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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 | SHEENA GARRARD
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Credential |
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Telephone | 870-723-1703
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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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Taxonomy #2
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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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