1487252771 NPI number — CHANGING SEASONS THERAPY AND CONSULTING, PLLC

Table of content: (NPI 1487252771)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487252771 NPI number — CHANGING SEASONS THERAPY AND CONSULTING, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHANGING SEASONS THERAPY AND CONSULTING, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487252771
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/09/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11649 WASHINGTON WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNDVILLE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35474-6360
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-534-2459
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1105 SOUTHVIEW LANE STE 103 #2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUSCALOOSA
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-534-2469
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/09/2020

Additional Information

Authorized Official

Authorized Official Last Name:
WASHINGTON
Authorized Official First Name:
LATONYA
Authorized Official Middle Name:
PATRECE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
205-534-2469

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com