Provider Demographics
NPI:1235997438
Name:BE THE CHANGE MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:BE THE CHANGE MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:LLOPIZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:786-704-4190
Mailing Address - Street 1:2217 NOVA VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33317-7031
Mailing Address - Country:US
Mailing Address - Phone:786-704-4190
Mailing Address - Fax:
Practice Address - Street 1:2217 NOVA VILLAGE DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33317-7031
Practice Address - Country:US
Practice Address - Phone:786-704-4190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty