Provider Demographics
NPI:1194867994
Name:CHANGING DIRECTIONS
Entity Type:Organization
Organization Name:CHANGING DIRECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT (OWNER)
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:LYNNETTA
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:205-492-2514
Mailing Address - Street 1:509 FAIR OAKS DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35064-2422
Mailing Address - Country:US
Mailing Address - Phone:205-492-2514
Mailing Address - Fax:205-923-2549
Practice Address - Street 1:CLIENTS' HOME ( IN HOME COUNSELING
Practice Address - Street 2:509 FAIR OAKS DR
Practice Address - City:FAIRFIELD
Practice Address - State:AL
Practice Address - Zip Code:35064-2422
Practice Address - Country:US
Practice Address - Phone:205-492-2514
Practice Address - Fax:205-923-2549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL257106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL339037218Medicaid