| Life Change Therapy Now Llc | |
|
21 Byte Ct Ste G Frederick MD 21702-8724 | |
| (301) 846-7872 | |
| (301) 846-7973 |
| Full Name | Life Change Therapy Now Llc |
|---|---|
| Speciality | Social Worker |
| Location | 21 Byte Ct Ste G, Frederick, Maryland |
| Authorized Official Name and Position | Lorena Ripoll (OWNER) |
| Authorized Official Contact | 3018467872 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Change Therapy Now Llc 21 Byte Ct Ste G Frederick MD 21702-8724 Ph: (301) 846-7872 | Life Change Therapy Now Llc 21 Byte Ct Ste G Frederick MD 21702-8724 Ph: (301) 846-7872 |
| NPI Number | 1780121392 |
|---|---|
| Provider Enumeration Date | 01/21/2017 |
| Last Update Date | 10/13/2022 |
| Certification Date | 10/13/2022 |
| Medicare PECOS PAC ID | 4284010117 |
|---|---|
| Medicare Enrollment ID | O20220930000074 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780121392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 19553 (Maryland) | Primary |
| Provider Name | Deborah A Hedges |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174269419 PECOS PAC ID: 2961713094 Enrollment ID: I20220929003493 |
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