Provider Demographics
NPI:1114644069
Name:SMALL CHANGE THERAPY, PLLC
Entity Type:Organization
Organization Name:SMALL CHANGE THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-321-8641
Mailing Address - Street 1:740 SW 109TH AVE # 318
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1340
Mailing Address - Country:US
Mailing Address - Phone:786-671-8071
Mailing Address - Fax:
Practice Address - Street 1:740 SW 109TH AVE # 318
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1340
Practice Address - Country:US
Practice Address - Phone:786-671-8071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty