Indelible Changes Llc is a Counselor Clinic in Woodbridge, Virginia. It is located at 12890 Harbor Dr, Woodbridge, VA and its contact number is 570-316-1020. The authorized person for Indelible Changes Llc is Mr. Nicholas Antonio Williams
who is Ceo of the clinic and his/her contact number is 703-474-0585. Indelible Changes Llc Clinic has counselors who are trained and educated in the performance of behavior health services through interpersonal communications and analysis. Counselors offer guidance to individuals, couples, families and groups who are dealing with issues that affect their mental health and well-being.
Complete Clinic Profile:
Indelible Changes Llc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Indelible Changes Llc
Specialization:
Counselor
Clinic Address:
12890 Harbor Dr, Woodbridge, Virginia, 22192-2921
Phone:
570-316-1020
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Mr. Nicholas Antonio Williams
Position:
Ceo
Contact Number:
703-474-0585
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Indelible Changes Llc clinic are as mentioned below.
NPI Number:
1720540107
NPI Enumeration Date:
03 Apr, 2019
NPI Last Update On:
14 Dec, 2022
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Indelible Changes Llc are as mentioned below.
Specialization
License Number
State
Status
Mental Health
Primary
Counselor
Secondary
Psychologist
Secondary
Social Worker
Secondary
Clinical
Secondary
Marriage & Family Therapist
Secondary
Mental Health (Including Community Mental Health Center)
Secondary
Adult Mental Health
Secondary
Adolescent and Children Mental Health
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
575326118
Medicaid
Virginia
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Indelible Changes Llc 4191 Waterway Dr, Dumfries, Virginia
Zip:
22025-1602
Phone Number:
703-474-0585
Patients can reach Indelible Changes Llc at 12890 Harbor Dr, Woodbridge, Virginia or can call to book an appointment on 570-316-1020. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.