Organization
CHANGING FACES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLE MAYWEATHER-BANKS LCSW (OWNER)
(860) 201-3688
Entity
Organization
Contact information
Practice address
4 DEXTER ST, WINDSOR, CT 06095-4410
(860) 201-3688
Mailing address
PO BOX 375, WINDSOR, CT 06095-4410
(860) 201-3688
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/06/2023
Last updated
01/06/2023
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