Provider Demographics
NPI:1881976488
Name:CHRISTIAN CHANGES COUNSELING & CONSULTING
Entity type:Organization
Organization Name:CHRISTIAN CHANGES COUNSELING & CONSULTING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE & CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDIE
Authorized Official - Middle Name:W
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, RPT-S
Authorized Official - Phone:662-338-1880
Mailing Address - Street 1:309 E LAMPKIN ST
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-2909
Mailing Address - Country:US
Mailing Address - Phone:662-338-1880
Mailing Address - Fax:662-338-1880
Practice Address - Street 1:309 E LAMPKIN ST
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-2909
Practice Address - Country:US
Practice Address - Phone:662-338-1880
Practice Address - Fax:662-338-1880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS696101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty