Provider Demographics
NPI:1386333656
Name:WINDS OF CHANGE RECOVERY AND MENTAL HEALTH LLC
Entity type:Organization
Organization Name:WINDS OF CHANGE RECOVERY AND MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HANEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:304-644-6620
Mailing Address - Street 1:3049 ROBERT C BYRD DR STE 360
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-4467
Mailing Address - Country:US
Mailing Address - Phone:304-953-3987
Mailing Address - Fax:
Practice Address - Street 1:3049 ROBERT C BYRD DR STE 360
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-4467
Practice Address - Country:US
Practice Address - Phone:304-953-3987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health