Provider Demographics
NPI:1255832523
Name:HOPEFUL CHANGE COUNSELING, PLLC
Entity Type:Organization
Organization Name:HOPEFUL CHANGE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHALISA
Authorized Official - Middle Name:BYERS
Authorized Official - Last Name:BYNUM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-582-1560
Mailing Address - Street 1:1404 TORREY PINES CT
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-7944
Mailing Address - Country:US
Mailing Address - Phone:704-582-1560
Mailing Address - Fax:
Practice Address - Street 1:1404 TORREY PINES CT
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-7944
Practice Address - Country:US
Practice Address - Phone:704-582-1560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health