Organization · Type 2 NPI

Changing Lives Therapeutic Service, LLC

Community/Behavioral Health Agency · Danville, VA

NPI number 1891317657 Active

Practice location

413 Mount Cross Rd Ste 102
Danville, VA 24540-4089

Call (888) 388-8726 Map

Mailing address

8825 University East Dr Ste 200
Charlotte, NC 28213-4395

Other practice locations

8825 University East Dr Ste 200, Charlotte, NC 28213-4395 · (980) 883-1121

Specialties and licenses

Taxonomy	Code	License
Professional Counselor	101YP2500X	None listed
Clinical Social Worker	1041C0700X	None listed
Peer Specialist	175T00000X	None listed
Community/Behavioral Health Agency Primary	251S00000X	None listed
Mental Health Clinic/Center (Including Community Mental Health Center)	261QM0801X	None listed
Substance Use Disorder Rehabilitation Clinic/Center	261QR0405X	None listed

Community/Behavioral Health Agency: A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day suppo…

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NPI record

NPI: 1891317657
Entity type: Organization (Type 2)
Issued: May 14, 2020
Last updated: Mar 24, 2025
Status: Active

Other names

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Changing Lives Therapeutic Service,llc · doing business as
Changing Lives Therapeutic Service,llc · doing business as

Authorized official

Cemetrius Rolle, LCSW
Co-Owner
(980) 833-1121

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1891317657

Changing Lives Therapeutic Service, LLC's National Provider Identifier is 1891317657, issued on May 14, 2020. The primary taxonomy on file is Community/Behavioral Health Agency (251S00000X), and the practice location is in Danville, VA. The record was last updated on Mar 24, 2025.