| Revolutionary Change Counseling Llc | |
|
1307 Apollo Beach Blvd S Unit 101 Apollo Beach FL 33572-3092 | |
| (813) 296-7911 | |
| (813) 200-1180 |
| Full Name | Revolutionary Change Counseling Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1307 Apollo Beach Blvd S Unit 101, Apollo Beach, Florida |
| Authorized Official Name and Position | Shaana Wilson (LMHC) |
| Authorized Official Contact | 8132967911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revolutionary Change Counseling Llc 1307 Apollo Beach Blvd S Unit 101 Apollo Beach FL 33572-3092 Ph: (813) 296-7911 | Revolutionary Change Counseling Llc 1307 Apollo Beach Blvd S Unit 101 Apollo Beach FL 33572-3092 Ph: (813) 296-7911 |
| NPI Number | 1811417645 |
|---|---|
| Provider Enumeration Date | 06/22/2017 |
| Last Update Date | 04/05/2024 |
| Certification Date | 04/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811417645 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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