| Southern Change Behavioral Health Services, Llc | |
|
8109 Mechanicsville Tpke Unit 2a Mechanicsville VA 23111-1209 | |
| (804) 446-4706 | |
| Not Available |
| Full Name | Southern Change Behavioral Health Services, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 8109 Mechanicsville Tpke Unit 2a, Mechanicsville, Virginia |
| Authorized Official Name and Position | Shaina Jenkins (OWNER) |
| Authorized Official Contact | 8042399597 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Change Behavioral Health Services, Llc 8109 Mechanicsville Tpke Unit 2a Mechanicsville VA 23111-1209 Ph: (804) 446-4706 | Southern Change Behavioral Health Services, Llc 8109 Mechanicsville Tpke Unit 2a Mechanicsville VA 23111-1209 Ph: (804) 446-4706 |
| NPI Number | 1225594922 |
|---|---|
| Provider Enumeration Date | 02/18/2019 |
| Last Update Date | 04/17/2023 |
| Certification Date | 04/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225594922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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