Provider Demographics
NPI:1487421269
Name:CHANGING SEASONS ART THERAPY LLC
Entity type:Organization
Organization Name:CHANGING SEASONS ART THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:LEAH
Authorized Official - Last Name:RUMMERY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, ATR-BC
Authorized Official - Phone:215-709-7174
Mailing Address - Street 1:30 S 15TH ST STE 533008
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-4826
Mailing Address - Country:US
Mailing Address - Phone:215-709-7174
Mailing Address - Fax:
Practice Address - Street 1:30 S 15TH ST STE 533008
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-4826
Practice Address - Country:US
Practice Address - Phone:215-709-7174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care