Organization
CHANGING CYCLES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEYONA SHANTRICE THOMAS-KELLY PSY.D., MA, LCPC (VICE-PRESIDENT AND COO)
(301) 357-6605
Entity
Organization
Contact information
Practice address
14460 OLD MILL RD, SUITE 201, UPPER MARLBORO, MD 20772-3092
(301) 357-6605
Mailing address
3475 LEONARDTOWN RD, SUITE 206, WALDORF, MD 20601-3678
(301) 357-6605
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC2555
MD
101YP2500X
Professional Counselor
PRC13986
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
440314200
—
MD
Enumeration date
08/29/2011
Last updated
03/15/2012
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