# A CHANCE FOR CHANGE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568094225
- **Authorized official:** MS. AMANDA COLEMON BA, PSYCHOLOGY, QMHP (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (980) 745-9867

## Contact information

- **Practice address:** 999 WATERSIDE DR STE 2525, NORFOLK, VA 23510-3316
- **Practice address phone:** (757) 777-3454
- **Practice address fax:** (757) 568-7437
- **Mailing address:** 999 WATERSIDE DR STE 2525, NORFOLK, VA 23510-3316
- **Mailing address phone:** (757) 777-3454
- **Mailing address fax:** (757) 568-7437

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | — |
| 171M00000X | Case Manager/Care Coordinator | — | — | — |
| 225C00000X | Rehabilitation Counselor | — | NULL | — |
| 225C00000X | Rehabilitation Counselor | — | — | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | — | NULL | — |
| 405300000X | Prevention Professional | — | NULL | — |
| 405300000X | Prevention Professional | — | — | — |

## Other

- **Enumeration date:** 02/10/2020
- **Last updated:** 08/03/2020