Organization
A CHANGE IN LIFE LLC
Active
Other names
A Change In Life LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH LAMONT SHELTON (OWNER/CEO)
(804) 716-1560
Entity
Organization
Contact information
Practice address
4901 FITZHUGH AVE STE 205, RICHMOND, VA 23230-3531
(804) 716-5960
(804) 997-7907
Mailing address
4901 FITZHUGH AVE STE 205, RICHMOND, VA 23230-3531
(804) 716-5960
(804) 997-7907
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
10/15/2019
Last updated
10/01/2021
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