| Changing Dynamics-changing Lives, Llc | |
|
706 W Brookland Park Blvd Richmond VA 23222-2515 | |
| (540) 455-2191 | |
| Not Available |
| Full Name | Changing Dynamics-changing Lives, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 706 W Brookland Park Blvd, Richmond, Virginia |
| Authorized Official Name and Position | Cheryl L Simms (CO-OWNER) |
| Authorized Official Contact | 5402708189 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Changing Dynamics-changing Lives, Llc 706 W Brookland Park Blvd Richmond VA 23222-2515 Ph: () - | Changing Dynamics-changing Lives, Llc 706 W Brookland Park Blvd Richmond VA 23222-2515 Ph: (540) 455-2191 |
| NPI Number | 1043516727 |
|---|---|
| Provider Enumeration Date | 01/28/2011 |
| Last Update Date | 01/28/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043516727 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 0710102319 (Virginia) | Secondary |
| 101YP2500X | Counselor - Professional | 07011004763 (Virginia) | Primary |
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