Provider Demographics
NPI:1801033394
Name:CHANGING SEASONS COUNSELING INC
Entity Type:Organization
Organization Name:CHANGING SEASONS COUNSELING INC
Other - Org Name:LAINA M. WINTERS, LCSW
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAINA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:WINTERS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:907-354-8506
Mailing Address - Street 1:PO BOX 298528
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99629-8528
Mailing Address - Country:US
Mailing Address - Phone:907-354-8506
Mailing Address - Fax:
Practice Address - Street 1:1435 N. OLD TOWNE DRIVE
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645
Practice Address - Country:US
Practice Address - Phone:907-354-8506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-21
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK12321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR147358Medicare PIN