Organization · Type 2 NPI

Indelible Changes LLC

Mental Health Counselor · Woodbridge, VA

NPI number 1720540107 Active

Practice location

12890 Harbor Dr
Woodbridge, VA 22192-2921

Call (570) 316-1020 Map

Mailing address

4191 Waterway Dr
Dumfries, VA 22025-1602

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000XNone listed
Mental Health Counselor Primary 101YM0800XNone listed
Psychologist 103T00000XNone listed
Social Worker 104100000XNone listed
Clinical Social Worker 1041C0700XNone listed
Marriage & Family Therapist 106H00000XNone listed
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801XNone listed
Adult Mental Health Clinic/Center 261QM0850XNone listed
Adolescent and Children Mental Health Clinic/Center 261QM0855XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1720540107

Indelible Changes LLC's National Provider Identifier is 1720540107, issued on Apr 3, 2019. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Woodbridge, VA. The record was last updated on Dec 14, 2022.