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General NPI Number Information
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NPI Number | 1790315828
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Entity Type | Organization
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Legal Business Name | CHANGING BEHAVIORS COUNSELING AGENCY, LLC
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Dates
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Enumeration Date | 01/16/2020
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 2400 TEXAS AVE UNIT 37776
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City | SHREVEPORT
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State | LA
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Zip | 71133-5083
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Country | US
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Telephone | 318-709-9933
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Fax | 318-670-8683
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Provider Business Mailing Address
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Address Line | PO BOX 37776
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City | SHREVEPORT
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State | LA
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Zip | 71133-7776
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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 | FOUNDER/CEO
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Name | REGINA R RYE
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Credential | MS, NCC, LPC, LAC
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Telephone | 318-232-8132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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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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