MEDICARE: CHANGING COURSE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1356146161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHANGING COURSE

Provider Business Mailing Address
First Line	:	7229 G ST
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-1870
Country	:	US
Telephone Number	:	301-326-7956
Fax Number	:

Provider Business Practice Location Address
First Line	:	7229 G ST
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-1870
Country	:	US
Telephone Number	:	301-326-7956
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HARRISON ALEXANDER WEST
Credential	:	LCSW-C
Telephone Number	:	301-326-7956

Provider Enumeration Date	:	02/17/2025
Last Update Date	:	02/17/2025

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Directions to “CHANGING COURSE ” Practice Location

Language	Start Address	Practice Location

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