Provider Demographics
NPI:1336512045
Name:THERAPEUTIC CHANGES, INC.
Entity Type:Organization
Organization Name:THERAPEUTIC CHANGES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:ARCHIE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:336-340-7651
Mailing Address - Street 1:8227 HARVEST BEND LN
Mailing Address - Street 2:APT 22
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-6154
Mailing Address - Country:US
Mailing Address - Phone:336-340-7651
Mailing Address - Fax:
Practice Address - Street 1:9701 PHILADELPHIA CT
Practice Address - Street 2:SUITE R
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4400
Practice Address - Country:US
Practice Address - Phone:336-340-7651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-03
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health