# BRANCHES OF CHANGE COUNSELING LLC

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

## Provider details

- **NPI number:** 1770202517
- **Authorized official:** LACEY MARIE FAUGHENDER LCSW (LCSW/ OWNER)
- **Authorized official phone:** (503) 902-5930

## Contact information

- **Practice address:** 161 HIGH ST SE STE 202, SALEM, OR 97301-3610
- **Practice address phone:** (509) 902-5930
- **Practice address fax:** (503) 917-5991
- **Mailing address:** 161 HIGH ST SE STE 202, SALEM, OR 97301-3610
- **Mailing address phone:** (509) 902-5930
- **Mailing address fax:** (503) 917-5991

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 08/24/2022
- **Last updated:** 08/24/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 500685336 | — | OR |