CHANGING GENERATIONAL LEGACIES,LLC (NPI# 1598012155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598012155 |
| Entity Type | Organization |
| Organization Name | CHANGING GENERATIONAL LEGACIES,LLC |
| Practice Address |
1401 Mercantile Ln Suite 200-q Largo MD 20774-4301 |
| Practice Telephone | 3013224141 |
| Practice Fax Number | 3013229199 |
| Mailing Telephone | 3013224141 |
| Mailing Fax Number | 3013229199 |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2012-08-13 |
| Authorized Official Name | MS. DEBRA JOYCE JOHNSON (CEO, FOUNDER) |
| Authorized Official Telephone | 3013224141 |
| Authorized Official Credential | MS, LCPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
LC3809 | MD | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 040457800 | 05 |
| Street Address |
1401 MERCANTILE LN SUITE 200-Q |
| City | LARGO |
| State | MD |
| Zip Code | 20774-4301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689663346 | Tania Chimwemwe Nkungula-howlett | Dentist | 1401 Mercantile Ln, Suite 102, Largo, MD 20774-4301 | 2005-10-17 |
| 1306396247 | Carlie-anne Samedy | Physical Therapist | 1401 Mercantile Ln, Suite 107, Largo, MD 20774-4301 | 2016-10-04 |
| 1316490816 | Love One Home Healthcare, Inc. | Home Health | 1401 Mercantile Ln, 200-j, Largo, MD 20774-4301 | 2016-08-01 |
| 1891039988 | Washington Oral Surgery Center, LLC | Clinic/Center | 1401 Mercantile Ln, Suite 102, Largo, MD 20774-4301 | 2012-11-15 |
| 1811271968 | Physical & Sports Rehab Inc | Physical Therapist | 1401 Mercantile Ln, Suite 107, Largo, MD 20774-4301 | 2011-10-07 |
| 1912202508 | Larosiliere Dental Associates | Dentist | 1401 Mercantile Ln, 102, Largo, MD 20774-4301 | 2011-01-13 |
| 1932403714 | Debra Joyce Johnson | Counselor | 1401 Mercantile Ln, Suite 200-q, Largo, MD 20774-4301 | 2011-01-07 |
| 1962725952 | Tender Loving Care Health Care Services Southeast, L.L.C. | Home Health | 1401 Mercantile Ln, Suite 351, Largo, MD 20774-4301 | 2010-03-05 |
| 1356592646 | Eulah Health Services | Day Training, Developmentally Disabled Services | 1401 Mercantile Ln, 200 U, Largo, MD 20774-4301 | 2008-10-04 |
| 1316008881 | Sakina R. Nesbit | Psychologist | 1401 Mercantile Ln, Suite 200-x2, Largo, MD 20774-4301 | 2006-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922637156 | Marie Charlotte Teboutsou Tsodzou | Nurse Practitioner | 9317 Lavall Drive, Upper Marlboro, MD 20774 | 2020-04-08 |
| 1467093443 | Richland Support Services Corp. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11551 Joyceton Drive, Upper Marlboro, MD 20774 | 2019-10-01 |
| 1770134124 | Alan L Kahn | Counselor | 301 Largo Rd., Largo, MD 20774 | 2019-09-26 |
| 1619522034 | Francisca Ifeoma Alintah | Registered Nurse | 511 Dennis Magruder Dr., Upper Marlboro, MD 20774 | 2019-08-02 |
| 1609337146 | Crystal Osuchukwu | Counselor | 1300 Mccormick Dr, Upper Marlboro, MD 20774 | 2019-03-27 |
| 1861968489 | Collaborative Concepts of Maryland | Counselor | 1400 Mercantile Lane, Suite 208, Largo, MD 20774 | 2018-10-22 |
| 1073097622 | Triple Angels Homecare Services, Inc. | In Home Supportive Care | 1210 Dixie Bowie Way, Upper Marlboro, MD 20774 | 2018-09-19 |
| 1922589654 | Optimum Resource Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 711 Harry S. Truman Dr, Unit #105, Largo, MD 20774 | 2018-08-21 |
| 1811475254 | Kolawole Richard Olatunde | Home Health Aide | 11405 Villa Court, Upper Marlboro, MD 20774 | 2018-07-28 |
| 1548747769 | Tiara Williams | Counselor | 15207 Harriet Clotilda Way, Upper Marlboro, MD 20774 | 2018-07-20 |
| Find all providers in zip 20774 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073120549 | Jacquean Lynette Kosh | Counselor | 711 Harry S Truman Dr Apt 210, Largo, MD 20774-2095 | 2020-09-28 |
| 1508472184 | Roland George Hollins Jr. | Counselor | 1300 Mercantile Ln Ste 129-40, Largo, MD 20774-5327 | 2020-09-19 |
| 1801422100 | Diversity Counseling Associates, LLC | Counselor | 1300 Mercantile Ln Ste 129-17, Largo, MD 20774-5327 | 2020-03-18 |
| 1770134124 | Alan L Kahn | Counselor | 301 Largo Rd., Largo, MD 20774 | 2019-09-26 |
| 1598227043 | Lavina Miranda Thompson Bowling | Counselor | 1300 Mercantile Ln Ste 198, Largo, MD 20774-5339 | 2019-04-03 |
| 1982161915 | Life Line Holdings, LLC | Counselor | 10225 Ulmerton Rd Ste 3a, Largo, FL 33771-3519 | 2019-02-26 |
| 1861968489 | Collaborative Concepts of Maryland | Counselor | 1400 Mercantile Lane, Suite 208, Largo, MD 20774 | 2018-10-22 |
| 1881638807 | Sandra Swary Hall | Counselor | 10825 Seminole Blvd, Unit 2a, Largo, FL 33778-3315 | 2006-06-16 |
| 1730706250 | Partnered Therapeutics Solutions | Counselor | 9701 Apollo Dr Ste 100, Largo, MD 20774-4785 | 2020-06-30 |
| 1912543752 | Jamila Hymon | Counselor | 1300 Mercantile Ln Ste 141, Largo, MD 20774-5331 | 2019-11-26 |
| Find all providers in LARGO | ||||
Please comment or provide details below to improve the information on CHANGING GENERATIONAL LEGACIES,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.