Provider Demographics
NPI:1487252771
Name:CHANGING SEASONS THERAPY AND CONSULTING, PLLC
Entity type:Organization
Organization Name:CHANGING SEASONS THERAPY AND CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:PATRECE
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, PIP
Authorized Official - Phone:205-534-2469
Mailing Address - Street 1:11649 WASHINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNDVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35474-6360
Mailing Address - Country:US
Mailing Address - Phone:205-534-2459
Mailing Address - Fax:
Practice Address - Street 1:1105 SOUTHVIEW LANE STE 103 #2
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405
Practice Address - Country:US
Practice Address - Phone:205-534-2469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty