Provider Demographics
NPI:1316700495
Name:WINDS OF CHANGE MARRIAGE AND FAMILY THERAPY, LLC.
Entity type:Organization
Organization Name:WINDS OF CHANGE MARRIAGE AND FAMILY THERAPY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:SYBIL
Authorized Official - Last Name:CECIL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, MFT, MSSW
Authorized Official - Phone:270-499-8268
Mailing Address - Street 1:600 WEST EVERLY BROTHERS BLVD
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42330-0601
Mailing Address - Country:US
Mailing Address - Phone:270-499-8268
Mailing Address - Fax:270-803-0670
Practice Address - Street 1:600 WEST EVERLY BROTHERS BLVD
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:KY
Practice Address - Zip Code:42330-0601
Practice Address - Country:US
Practice Address - Phone:270-499-8268
Practice Address - Fax:270-803-0670
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINDS OF CHANGE MARRIAGE AND FAMILY THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty