Provider Demographics
NPI:1558945758
Name:CHANGING PHASES INTERNATIONAL LLC
Entity Type:Organization
Organization Name:CHANGING PHASES INTERNATIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBBINS
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHP-R
Authorized Official - Phone:757-532-1654
Mailing Address - Street 1:1285 N KING ST STE 16
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-2233
Mailing Address - Country:US
Mailing Address - Phone:757-532-1654
Mailing Address - Fax:
Practice Address - Street 1:1285 N KING ST STE 16
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-2233
Practice Address - Country:US
Practice Address - Phone:757-532-1654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty