Provider Demographics
NPI:1396492633
Name:READY FOR CHANGE THERAPEUTIC INTERVENTIONS PLLC
Entity type:Organization
Organization Name:READY FOR CHANGE THERAPEUTIC INTERVENTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER CLINICAL/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:888-732-8471
Mailing Address - Street 1:3746 CORBETT RD
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-7811
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12 CORNWALL RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:CT
Practice Address - Zip Code:06754-1715
Practice Address - Country:US
Practice Address - Phone:888-732-8471
Practice Address - Fax:877-207-3345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty