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Organization
REVOLUTIONARY CHANGE COUNSELING LLC
Active
Organization
REVOLUTIONARY CHANGE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAANA WILSON M.S (LMHC)
(813) 410-7025
Entity
Organization
Contact information
Practice address
1307 APOLLO BEACH BLVD S UNIT 101, APOLLO BEACH, FL 33572-3092
(813) 410-7025
(813) 200-1180
Mailing address
1307 APOLLO BEACH BLVD S UNIT 101, APOLLO BEACH, FL 33572-3092
(813) 410-7025
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010658700
—
FL
05
—
120613000
—
FL
Enumeration date
06/22/2017
Last updated
05/21/2025
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