| Change In Motion | |
|
1850 Lee Rd Ste 322 Winter Park FL 32789-2107 | |
| (407) 637-2633 | |
| (407) 558-3438 |
| Full Name | Change In Motion |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1850 Lee Rd Ste 322, Winter Park, Florida |
| Authorized Official Name and Position | Lanicia Cain (OWNER) |
| Authorized Official Contact | 4075759102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Change In Motion 1850 Lee Rd Ste 322 Winter Park FL 32789-2107 Ph: (407) 637-2633 | Change In Motion 1850 Lee Rd Ste 322 Winter Park FL 32789-2107 Ph: (407) 637-2633 |
| NPI Number | 1821469396 |
|---|---|
| Provider Enumeration Date | 10/09/2015 |
| Last Update Date | 04/05/2021 |
| Certification Date | 03/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821469396 | NPI | - | NPPES |
| 101840100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | IMH15376 (Florida) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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