Provider Demographics
NPI:1568351120
Name:WINGS OF CHANGE LLC
Entity type:Organization
Organization Name:WINGS OF CHANGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GARBER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:720-819-6923
Mailing Address - Street 1:1905 SHERMAN STREET
Mailing Address - Street 2:STE 200 #2198
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203
Mailing Address - Country:US
Mailing Address - Phone:720-819-6923
Mailing Address - Fax:
Practice Address - Street 1:1150 GALAPAGO ST APT 222
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-3576
Practice Address - Country:US
Practice Address - Phone:720-819-6923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty