MEDICARE: MAKING CHANGES COUNSELING LLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1861186868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAKING CHANGES COUNSELING LLC

Provider Business Mailing Address
First Line	:	4655 OSAGE BEACH PARKWAY STE A #241
Second Line	:
City	:	OSAGE BEACH
State	:	MO
Zip	:	65065
Country	:	US
Telephone Number	:	407-308-2871
Fax Number	:

Provider Business Practice Location Address
First Line	:	4655 OSAGE BEACH PARKWAY STE A #241
Second Line	:
City	:	OSAGE BEACH
State	:	MO
Zip	:	65065
Country	:	US
Telephone Number	:	407-308-2871
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SARAH ROQUE
Credential	:	LMHC, LPC
Telephone Number	:	407-308-2871

Provider Enumeration Date	:	06/05/2023
Last Update Date	:	06/05/2023

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