Provider Demographics
NPI:1821989500
Name:THERAPEUTIC CHANGE WITH PURPOSE, LLC
Entity type:Organization
Organization Name:THERAPEUTIC CHANGE WITH PURPOSE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:703-829-5755
Mailing Address - Street 1:8987 COTSWOLD DR
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1601
Mailing Address - Country:US
Mailing Address - Phone:703-829-5755
Mailing Address - Fax:
Practice Address - Street 1:8987 COTSWOLD DR
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-1601
Practice Address - Country:US
Practice Address - Phone:703-829-5755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health