| Changes Counseling Center, Llc | |
|
2811 Tricom St North Charleston SC 29406-9172 | |
| (919) 354-0840 | |
| (855) 420-6402 |
| Full Name | Changes Counseling Center, Llc |
|---|---|
| Speciality | Counselor |
| Location | 2811 Tricom St, North Charleston, South Carolina |
| Authorized Official Name and Position | Jasmine Spaulding (SUPERVISOR) |
| Authorized Official Contact | 9165767893 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Changes Counseling Center, Llc 3835 N Freeway Blvd Ste 100 Sacramento CA 95834-1954 Ph: (916) 576-7893 | Changes Counseling Center, Llc 2811 Tricom St North Charleston SC 29406-9172 Ph: (919) 354-0840 |
| NPI Number | 1225344096 |
|---|---|
| Provider Enumeration Date | 08/31/2010 |
| Last Update Date | 08/30/2023 |
| Certification Date | 08/30/2023 |
| Medicare PECOS PAC ID | 3072895655 |
|---|---|
| Medicare Enrollment ID | O20170113001528 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225344096 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 4771 (South Carolina) | Primary |
| Provider Name | Madelyn Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225086119 PECOS PAC ID: 6709783806 Enrollment ID: I20031217000279 |
| Provider Name | Mary E Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760680540 PECOS PAC ID: 9436164266 Enrollment ID: I20060215000033 |
| Provider Name | Christine Diane Hamolia |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1902914856 PECOS PAC ID: 0446449888 Enrollment ID: I20110114000999 |
| Provider Name | Joseph M Ritchey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598178402 PECOS PAC ID: 8022235589 Enrollment ID: I20140807001237 |
| Provider Name | Tonia M Cassaday |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588897706 PECOS PAC ID: 0840582201 Enrollment ID: I20160706001362 |
| Provider Name | Bryan A West |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932494093 PECOS PAC ID: 9931429529 Enrollment ID: I20170410001128 |
| Provider Name | Steven Sinderman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508810623 PECOS PAC ID: 2264476886 Enrollment ID: I20171013002551 |
| Provider Name | Maureen C Apollo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790288876 PECOS PAC ID: 4981950334 Enrollment ID: I20180627003250 |
| Provider Name | Sarah Kemp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164677217 PECOS PAC ID: 6507297744 Enrollment ID: I20200504001193 |
| Provider Name | Amanda Washburn Forbus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275726754 PECOS PAC ID: 0840609475 Enrollment ID: I20210511001193 |
| Provider Name | Vernell D. Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558562942 PECOS PAC ID: 2860898475 Enrollment ID: I20210907003632 |
| Provider Name | Jennifer Marie Shierlock |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841671344 PECOS PAC ID: 8426454869 Enrollment ID: I20210909002000 |
| Provider Name | Lee Blackmon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417489774 PECOS PAC ID: 8123392339 Enrollment ID: I20211007000768 |
| Provider Name | Brad Martin Wuerfel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790104099 PECOS PAC ID: 9739306077 Enrollment ID: I20220128002031 |
| Provider Name | Reya A Demirozu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629735451 PECOS PAC ID: 3678966389 Enrollment ID: I20220201002401 |
| Provider Name | Michele Blanch-barr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245319342 PECOS PAC ID: 9133512692 Enrollment ID: I20220204000002 |
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