CHANGING LIVES COUNSELING AND MENTORING, LLC (NPI# 1194176792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194176792 |
| Entity Type | Organization |
| Organization Name | CHANGING LIVES COUNSELING AND MENTORING, LLC |
| Practice Address |
202 Lake St Lake Providence LA 71254 |
| Mailing Address |
202 Lake St Lake Providence LA 71254-2628 |
| Practice Telephone | 3185525126 |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2018-06-27 |
| Authorized Official Name | MR. JASON RICHARDSON (OWNER) |
| Authorized Official Telephone | 3185575126 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | LA | Agencies | |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
202 LAKE ST |
| City | LAKE PROVIDENCE |
| State | LA |
| Zip Code | 71254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962995688 | Kanitra Elmore | Registered Nurse | 202 Lake St, Lake Providence, LA 71254-2628 | 2018-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225571821 | Sade' Finley | Counselor | 1700 Lake Street, Lake Providence, LA 71254 | 2016-11-30 |
| 1326494972 | Ingrid Dandrea Lockhart | Counselor | 1700 Lake Road, Lake Providence, LA 71254 | 2016-05-12 |
| 1013183003 | Personal Careall | Hospice Care, Community Based | 3959 Schrock Drive, Lake Providence, LA 71254 | 2008-04-30 |
| 1750310272 | George Fakhre | Internal Medicine | 221 N Hood, Lake Providence, LA 71254 | 2006-06-30 |
| 1194239806 | Shirley Anne Lyons | Counselor | 1700 Lake St, Lake Providence, LA 71254 | 2017-11-17 |
| 1225588700 | Courtney Michelle Wingate | Counselor | 1700 Lake St, Lake Providence, LA 71254 | 2016-10-10 |
| 1649622721 | Keanda Walker | Counselor | 1700 Lake St, Lake Providence, LA 71254 | 2016-07-12 |
| 1346698792 | Tonya Denise Gordon | Counselor | 1700 Lake St, Lake Providence, LA 71254 | 2016-05-26 |
| 1356797971 | Sheila Bell | Counselor | 1700 Lake St, Lake Providence, LA 71254 | 2016-05-12 |
| 1548616121 | Helen Jackson | Counselor | 1700 Lake St, Lake Providence, LA 71254 | 2016-05-12 |
| Find all providers in zip 71254 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417489097 | Heather King | Counselor | 272 Keene St, Lake Providence, LA 71254-5656 | 2017-04-01 |
| 1124550710 | Laketha Lyons | Counselor | 331 Keene St, Lake Providence, LA 71254-5662 | 2017-04-01 |
| 1255863833 | Kaleisha Lewis | Counselor | 1431 Mike Ave, Lake Providence, LA 71254-3653 | 2017-04-01 |
| 1962934554 | Kim Powell | Counselor | 301 Madden Dr, Lake Providence, LA 71254-3742 | 2017-04-01 |
| 1003348681 | Wanda Shoemaker | Counselor | 306 Star Arlington St, Lake Providence, LA 71254-2012 | 2017-04-01 |
| 1225571821 | Sade' Finley | Counselor | 1700 Lake Street, Lake Providence, LA 71254 | 2016-11-30 |
| 1326494972 | Ingrid Dandrea Lockhart | Counselor | 1700 Lake Road, Lake Providence, LA 71254 | 2016-05-12 |
| 1306317953 | Alisa Bell | Counselor | 411 Sparrow St, Lake Providence, LA 71254-3035 | 2018-12-07 |
| 1194239806 | Shirley Anne Lyons | Counselor | 1700 Lake St, Lake Providence, LA 71254 | 2017-11-17 |
| 1285146787 | Renada Corletha Thompson | Counselor | 1700 Lake St, Lake Providence, LA 71254-5208 | 2017-10-25 |
| Find all providers in LAKE PROVIDENCE | ||||
| City | LAKE PROVIDENCE |
| Zip Code | 71254 |
Please comment or provide details below to improve the information on CHANGING LIVES COUNSELING AND MENTORING, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.