Provider Demographics
NPI:1932716222
Name:CHANGING DIRECTIONS PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:CHANGING DIRECTIONS PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:ABIGAIL
Authorized Official - Last Name:INGE-LINCHIM
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:714-434-3980
Mailing Address - Street 1:17280 NEWHOPE STREET
Mailing Address - Street 2:SUITE 4
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708
Mailing Address - Country:US
Mailing Address - Phone:714-434-3980
Mailing Address - Fax:714-434-3981
Practice Address - Street 1:17280 NEWHOPE STREET
Practice Address - Street 2:SUITE 4
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708
Practice Address - Country:US
Practice Address - Phone:714-434-3980
Practice Address - Fax:714-434-3981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty