Organization
CHANGE YOUR LIFE ENTERPRISES, INC.
Active
Other names
ADAPT, GRIP & Stephenie Roberts, LSCSW
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHENIE ANN ROBERTS LSCSW (PRESIDENT/OWNER)
(316) 721-0971
Entity
Organization
Contact information
Practice address
9505 W. CENTRAL, STE. 103, WICHITA, KS 67212-3832
(316) 721-0971
(316) 512-4070
Mailing address
9505 W. CENTRAL, STE. 103, WICHITA, KS 67212-3832
(316) 721-0971
(316) 512-4070
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
KS
1041C0700X
Clinical Social Worker
1949
KS
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
547
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
565012
—
KS
Enumeration date
01/10/2006
Last updated
07/15/2011
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