Organization
CHANGING DYNAMICS-CHANGING LIVES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHERYL L SIMMS MA, LPC, CSAC (CO-OWNER)
(540) 270-8189
Entity
Organization
Contact information
Practice address
706 W BROOKLAND PARK BLVD, RICHMOND, VA 23222-2515
(540) 455-2191
Mailing address
706 W BROOKLAND PARK BLVD, RICHMOND, VA 23222-2515
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710102319
VA
101YP2500X
Professional Counselor
Primary
07011004763
VA
Other
Enumeration date
01/28/2011
Last updated
01/28/2011
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