| Life Change Therapy Llc | |
|
303 S Water St Ste 230 Henderson NV 89015-7308 | |
| (725) 244-7223 | |
| (725) 215-9766 |
| Full Name | Life Change Therapy Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 303 S Water St Ste 230, Henderson, Nevada |
| Authorized Official Name and Position | David Michael Rogers (CEO/CLINICAL DIRECTOR-PRACTITIONER) |
| Authorized Official Contact | 7252447223 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Change Therapy Llc 303 S Water St Ste 230 Henderson NV 89015-7308 Ph: (725) 244-7223 | Life Change Therapy Llc 303 S Water St Ste 230 Henderson NV 89015-7308 Ph: (725) 244-7223 |
| NPI Number | 1871192401 |
|---|---|
| Provider Enumeration Date | 10/24/2020 |
| Last Update Date | 05/28/2026 |
| Certification Date | 05/28/2026 |
| Medicare PECOS PAC ID | 2365854932 |
|---|---|
| Medicare Enrollment ID | O20201224000422 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871192401 | NPI | - | NPPES |
| Provider Name | David M Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114209749 PECOS PAC ID: 2668732694 Enrollment ID: I20180212001617 |
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