Indelible Changes Llc

LBN: Indelible Changes Llc
Indelible Changes Llc is an health care organization with primary practice located at 12890 Harbor Dr , Woodbridge VA 22192-2921. The organization recently has 9 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Adolescent and Children Mental Health. Behavioral Health & Social Service Providers / Mental Health is the primary health care specialty. Indelible Changes Llc can be contacted via phone (570) 316-1020, or through Williams, Nicholas Antonio via phone (703) 474-0585.

Contact Information

Primary practice address
12890 Harbor Dr Woodbridge VA 22192-2921
Fax:
Website:
Authorized official contact:
Name: Williams, Nicholas Antonio Licensed Professional Counselor (LPC)

Profile Details

NPI number 1720540107
LBN Legal business name Indelible Changes Llc
DBA Doing business as
Authorized official Williams, Nicholas Antonio Licensed Professional Counselor (LPC)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 3rd, 2019
Last updated Dec 14th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720540107 NPPES
Virginia MEDICAID 575326118

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