Provider Demographics
NPI:1154997138
Name:CALIBRATE CHANGE LLC
Entity type:Organization
Organization Name:CALIBRATE CHANGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:CORONADO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC-A
Authorized Official - Phone:512-563-1899
Mailing Address - Street 1:3101 WELLS BRANCH PKWY APT 931
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-6625
Mailing Address - Country:US
Mailing Address - Phone:512-563-1899
Mailing Address - Fax:
Practice Address - Street 1:3101 WELLS BRANCH PKWY APT 931
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-6625
Practice Address - Country:US
Practice Address - Phone:512-563-1899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOURISH COUNSELING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty