Provider Demographics
NPI:1316720774
Name:BE THE CHANGE THERAPEUTIC SERVICES LLC
Entity type:Organization
Organization Name:BE THE CHANGE THERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:CASON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-816-1536
Mailing Address - Street 1:1411 RAMSHORN WAY
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7436
Mailing Address - Country:US
Mailing Address - Phone:757-816-1536
Mailing Address - Fax:
Practice Address - Street 1:1411 RAMSHORN WAY
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-7436
Practice Address - Country:US
Practice Address - Phone:757-816-1536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-17
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty