| Creating Change, Pllc | |
|
10130 Mallard Creek Rd Ste 300 Charlotte NC 28262-6001 | |
| (704) 807-4366 | |
| (704) 944-3101 |
| Full Name | Creating Change, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 10130 Mallard Creek Rd Ste 300, Charlotte, North Carolina |
| Authorized Official Name and Position | Shuantia Barber (FOUNDER/CEO) |
| Authorized Official Contact | 3363415994 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Creating Change, Pllc 10130 Mallard Creek Rd Ste 300 Charlotte NC 28262-6001 Ph: (704) 807-4366 | Creating Change, Pllc 10130 Mallard Creek Rd Ste 300 Charlotte NC 28262-6001 Ph: (704) 807-4366 |
| NPI Number | 1386244481 |
|---|---|
| Provider Enumeration Date | 10/28/2020 |
| Last Update Date | 10/28/2020 |
| Certification Date | 10/28/2020 |
| Medicare PECOS PAC ID | 5496168718 |
|---|---|
| Medicare Enrollment ID | O20210106000444 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386244481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Shuantia Barber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740667195 PECOS PAC ID: 1658622923 Enrollment ID: I20180925004115 |
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