Provider Demographics
NPI:1205434263
Name:CHANGING STORIES LLC
Entity type:Organization
Organization Name:CHANGING STORIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDWITH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:475-300-8130
Mailing Address - Street 1:30 MAIN ST FL 1
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-2506
Mailing Address - Country:US
Mailing Address - Phone:475-300-8130
Mailing Address - Fax:203-891-5976
Practice Address - Street 1:30 MAIN ST FL 1
Practice Address - Street 2:
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06512-2506
Practice Address - Country:US
Practice Address - Phone:475-300-8130
Practice Address - Fax:203-891-5976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty