Provider Demographics
NPI:1215494588
Name:CHANGING PERSPECTIVES LLC
Entity type:Organization
Organization Name:CHANGING PERSPECTIVES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:RUSHAWNA
Authorized Official - Middle Name:KABUKI
Authorized Official - Last Name:MELEYAH
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-449-3309
Mailing Address - Street 1:8307 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-2961
Mailing Address - Country:US
Mailing Address - Phone:443-449-3309
Mailing Address - Fax:
Practice Address - Street 1:8307 PHILADELPHIA RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-2961
Practice Address - Country:US
Practice Address - Phone:443-449-3309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1841739208Medicaid