| Changing Cycles, Llc | |
|
14460 Old Mill Rd Suite 201 Upper Marlboro MD 20772-3092 | |
| (301) 357-6605 | |
| Not Available |
| Full Name | Changing Cycles, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 14460 Old Mill Rd, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Keyona Shantrice Thomas-kelly (VICE-PRESIDENT AND COO) |
| Authorized Official Contact | 3013576605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Changing Cycles, Llc 3475 Leonardtown Rd Suite 206 Waldorf MD 20601-3678 Ph: (301) 357-6605 | Changing Cycles, Llc 14460 Old Mill Rd Suite 201 Upper Marlboro MD 20772-3092 Ph: (301) 357-6605 |
| NPI Number | 1265713705 |
|---|---|
| Provider Enumeration Date | 08/29/2011 |
| Last Update Date | 03/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265713705 | NPI | - | NPPES |
| 440314200 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LC2555 (Maryland) | Primary |
| 101YP2500X | Counselor - Professional | PRC13986 (District Of Columbia) | Secondary |
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