Provider Demographics
NPI:1396945549
Name:FOUNDATIONS FOR CHANGE, P.C.
Entity type:Organization
Organization Name:FOUNDATIONS FOR CHANGE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUKIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-262-1550
Mailing Address - Street 1:706 TODDS LN
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-1847
Mailing Address - Country:US
Mailing Address - Phone:757-262-1550
Mailing Address - Fax:757-262-1544
Practice Address - Street 1:706 TODDS LN
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-1847
Practice Address - Country:US
Practice Address - Phone:757-262-1550
Practice Address - Fax:757-262-1544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty