| Be The Change Counseling Services, Llc | |
|
800 Blanton Ave Richmond VA 23221-3603 | |
| (804) 621-2650 | |
| (804) 369-9709 |
| Full Name | Be The Change Counseling Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 800 Blanton Ave, Richmond, Virginia |
| Authorized Official Name and Position | Mary Anne Taylor (OWNER) |
| Authorized Official Contact | 8046212650 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Be The Change Counseling Services, Llc 1605 White Cedar Ln N Chesterfld VA 23235-5449 Ph: (804) 621-2650 | Be The Change Counseling Services, Llc 800 Blanton Ave Richmond VA 23221-3603 Ph: (804) 621-2650 |
| NPI Number | 1487148359 |
|---|---|
| Provider Enumeration Date | 06/14/2018 |
| Last Update Date | 12/13/2023 |
| Certification Date | 12/13/2023 |
| Medicare PECOS PAC ID | 9335499920 |
|---|---|
| Medicare Enrollment ID | O20180831000193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487148359 | NPI | - | NPPES |
| 800002554 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904004430 (Virginia) | Primary |
| Provider Name | Mary A Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962401836 PECOS PAC ID: 4688853575 Enrollment ID: I20110125000217 |
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