Provider Demographics
NPI:1013706654
Name:SEEDS OF CHANGE COUNSELING, LLC
Entity type:Organization
Organization Name:SEEDS OF CHANGE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:DE LA CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP, LPC
Authorized Official - Phone:314-629-2315
Mailing Address - Street 1:528 2ND ST
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NE
Mailing Address - Zip Code:68843-9336
Mailing Address - Country:US
Mailing Address - Phone:314-629-2315
Mailing Address - Fax:
Practice Address - Street 1:528 2ND ST
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NE
Practice Address - Zip Code:68843-9336
Practice Address - Country:US
Practice Address - Phone:314-629-2315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty