Provider Demographics
NPI:1922986157
Name:METANOIA SPA LLC
Entity type:Organization
Organization Name:METANOIA SPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/HEALTH COACH
Authorized Official - Prefix:MISS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:240-229-5948
Mailing Address - Street 1:511 BRIER CROSSINGS LOOP
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-9839
Mailing Address - Country:US
Mailing Address - Phone:240-229-5948
Mailing Address - Fax:240-229-5948
Practice Address - Street 1:511 BRIER CROSSINGS LOOP
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-9839
Practice Address - Country:US
Practice Address - Phone:240-229-5948
Practice Address - Fax:240-229-5948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-25
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency