Provider Demographics
NPI:1992480982
Name:CHANGING INSIGHT II, LLC
Entity type:Organization
Organization Name:CHANGING INSIGHT II, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EX DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHATANYA
Authorized Official - Middle Name:LASHAWN
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-280-9432
Mailing Address - Street 1:219 MARSHALL GRAVES RD
Mailing Address - Street 2:
Mailing Address - City:YANCEYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27379-8797
Mailing Address - Country:US
Mailing Address - Phone:336-280-9432
Mailing Address - Fax:
Practice Address - Street 1:7973 HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:LONGS
Practice Address - State:SC
Practice Address - Zip Code:29568-6201
Practice Address - Country:US
Practice Address - Phone:336-280-9432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty