Provider Demographics
NPI:1790061471
Name:STABLE CHANGES LLC
Entity Type:Organization
Organization Name:STABLE CHANGES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERLEBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:414-581-9291
Mailing Address - Street 1:1327 S 73RD ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-3134
Mailing Address - Country:US
Mailing Address - Phone:414-581-9291
Mailing Address - Fax:414-445-0989
Practice Address - Street 1:1439 92ND ST
Practice Address - Street 2:
Practice Address - City:FRANKSVILLE
Practice Address - State:WI
Practice Address - Zip Code:53126-9710
Practice Address - Country:US
Practice Address - Phone:414-581-9291
Practice Address - Fax:414-445-0989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-26
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health