Provider Demographics
NPI:1447237771
Name:WINDS OF CHANGE COUNSELING AND CONSULTING SERVICE INC.
Entity Type:Organization
Organization Name:WINDS OF CHANGE COUNSELING AND CONSULTING SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELDON
Authorized Official - Middle Name:R
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, MS
Authorized Official - Phone:765-584-7409
Mailing Address - Street 1:211 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:IN
Mailing Address - Zip Code:47394-1824
Mailing Address - Country:US
Mailing Address - Phone:765-584-7409
Mailing Address - Fax:765-584-1908
Practice Address - Street 1:211 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:IN
Practice Address - Zip Code:47394-1824
Practice Address - Country:US
Practice Address - Phone:765-584-7409
Practice Address - Fax:765-584-1908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN7049077OtherAETNA GROUP #
IN000000321933OtherBC/BS GROUP #
IN000000490923OtherBCBS
IN226209OtherTRICARE GROUP #
IN488743OtherVALUE OPTIONS GRP #
IN000000321933OtherBC/BS GROUP #
IN239400Medicare ID - Type UnspecifiedMEDICARE #