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Organization

CHANGE INSTITUTE CENTER

Active
Other names
Change Institute Center
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LORETTA LOVON HENDERSON MA, MS (EXECUTIVE DIRECTOR)
(832) 741-9457
Entity
Organization

Contact information

Practice address
8888 W BELLFORT ST, HOUSTON, TX 77031-2406
(832) 741-9457
(713) 988-2820
Mailing address
PO BOX 710253, HOUSTON, TX 77271-0253
(832) 741-9457
(713) 988-2820

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
TX
104100000X
Social Worker
TX
1041C0700X
Clinical Social Worker
TX
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
07/23/2011
Last updated
07/23/2011
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