| Changeworks Psychotherapy & Life Coaching Services, Llc | |
|
9218 Centreville Rd Manassas VA 20110-5131 | |
| (703) 626-0381 | |
| Not Available |
| Full Name | Changeworks Psychotherapy & Life Coaching Services, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 9218 Centreville Rd, Manassas, Virginia |
| Authorized Official Name and Position | Maureen Fannin (PRESIDENT) |
| Authorized Official Contact | 7036260381 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Changeworks Psychotherapy & Life Coaching Services, Llc 9218 Centreville Rd Manassas VA 20110-5131 Ph: () - | Changeworks Psychotherapy & Life Coaching Services, Llc 9218 Centreville Rd Manassas VA 20110-5131 Ph: (703) 626-0381 |
| NPI Number | 1326091844 |
|---|---|
| Provider Enumeration Date | 05/18/2006 |
| Last Update Date | 11/26/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326091844 | NPI | - | NPPES |
| 10141788 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904004708 (Virginia) | Primary |
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