Provider Demographics
NPI:1407432750
Name:A TIME FOR CHANGE, LLC
Entity Type:Organization
Organization Name:A TIME FOR CHANGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZALUSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-389-1504
Mailing Address - Street 1:512 S LYNNHAVEN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-6664
Mailing Address - Country:US
Mailing Address - Phone:757-306-4232
Mailing Address - Fax:
Practice Address - Street 1:512 S LYNNHAVEN RD STE 101
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-6664
Practice Address - Country:US
Practice Address - Phone:757-306-4232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty