Organization
CHATANDCHANGE COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CANDICE JARVIS LCSW (OWNER)
(631) 418-4117
Entity
Organization
Contact information
Practice address
727 N BROADWAY, MASSAPEQUA, NY 11758-2348
(631) 418-4117
Mailing address
615 BROADWAY, APT 31, AMITYVILLE, NY 11701-2137
(631) 418-4117
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
RO55452-1
NY
Other
Enumeration date
05/14/2016
Last updated
05/14/2016
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