Provider Demographics
NPI:1952851743
Name:CHANGES PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:CHANGES PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KIRSTEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCNELIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:202-734-0535
Mailing Address - Street 1:1627 K ST NW STE 500
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1708
Mailing Address - Country:US
Mailing Address - Phone:202-734-0535
Mailing Address - Fax:
Practice Address - Street 1:1627 K ST NW STE 500
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1708
Practice Address - Country:US
Practice Address - Phone:202-734-0535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2023-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1001166103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty