Provider Demographics
NPI:1780121392
Name:LIFE CHANGE THERAPY NOW LLC
Entity type:Organization
Organization Name:LIFE CHANGE THERAPY NOW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIPOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-846-7872
Mailing Address - Street 1:21 BYTE CT STE G
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-8724
Mailing Address - Country:US
Mailing Address - Phone:301-846-7872
Mailing Address - Fax:301-846-7973
Practice Address - Street 1:21 BYTE CT STE G
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-8724
Practice Address - Country:US
Practice Address - Phone:301-846-7872
Practice Address - Fax:301-846-7973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-21
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD195531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty