# THERAPEUTIC CHANGE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Therapeutic Change PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821653239
- **Authorized official:** SUMMER LYN BROWN M.S. (OWNER/ CLINICIAN)
- **Authorized official phone:** (360) 602-1477

## Contact information

- **Practice address:** 1314 KAUFFMAN AVE, VANCOUVER, WA 98660-2725
- **Practice address phone:** (360) 602-1477
- **Practice address fax:** (360) 334-5508
- **Mailing address:** 1314 KAUFFMAN AVE, VANCOUVER, WA 98660-2725
- **Mailing address phone:** (360) 602-1477
- **Mailing address fax:** (360) 334-5508

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/01/2019
- **Last updated:** 05/01/2019