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General NPI Number Information
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NPI Number | 1881468932
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Entity Type | Organization
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Legal Business Name | CHANGING THE CYCLE 2 LICENSED CLINICAL SOCIAL WORKER, INC.
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Dates
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Enumeration Date | 11/09/2023
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 1311 E PALMDALE BLVD STE 14
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City | PALMDALE
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State | CA
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Zip | 93550-2019
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Country | US
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Telephone | 661-228-0567
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Fax | 619-241-2678
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Provider Business Mailing Address
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Address Line | 1311 E PALMDALE BLVD STE 14
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City | PALMDALE
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State | CA
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Zip | 93550-2019
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Country | US
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Telephone | 661-228-0567
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Fax | 619-241-2678
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Authorized Official
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Title or Position | CEO
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Name | DAVID RICHARDS
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Credential | LCSW
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Telephone | 661-228-0567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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