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Organization

CHANGIN' YOU

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMISE BROWN LPC,LSATP, SOTP,PH.D (CEO)
(813) 562-2925
Entity
Organization

Contact information

Practice address
7639 HULL STREET RD STE 102, NORTH CHESTERFIELD, VA 23235-6438
(804) 502-2167
(804) 709-3919
Mailing address
6415 OMO RD, NORTH CHESTERFIELD, VA 23234-5881
(813) 562-2925
(807) 709-3919

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
251S00000X
Community/Behavioral Health Agency
Primary
324500000X
Substance Abuse Rehabilitation Facility
3245S0500X
Children's Substance Abuse Rehabilitation Facility

Other

Enumeration date
03/25/2024
Last updated
03/04/2026
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