Provider Demographics
NPI:1881224194
Name:CHANGED MINDS LLC
Entity Type:Organization
Organization Name:CHANGED MINDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LIZBETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:VELIZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:201-889-3401
Mailing Address - Street 1:286 OREGON ST
Mailing Address - Street 2:
Mailing Address - City:VAUXHALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07088-1319
Mailing Address - Country:US
Mailing Address - Phone:908-858-6772
Mailing Address - Fax:
Practice Address - Street 1:286 OREGON ST
Practice Address - Street 2:
Practice Address - City:VAUXHALL
Practice Address - State:NJ
Practice Address - Zip Code:07088-1319
Practice Address - Country:US
Practice Address - Phone:908-858-6772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-26
Last Update Date:2020-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health