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Organization

THE CENTER FOR CHANGE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MORGAN RODRIGUEZ (MANAGER)
(702) 945-8846
Entity
Organization

Contact information

Practice address
4535 W RUSSELL RD STE 15, LAS VEGAS, NV 89118-2258
(702) 368-2380
(702) 368-2380
Mailing address
4535 W RUSSELL RD STE 15, LAS VEGAS, NV 89118-2258
(702) 368-2380
(702) 368-2316

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
103K00000X
Behavior Analyst
103T00000X
Psychologist
103TC0700X
Clinical Psychologist
Primary
103TC2200X
Clinical Child & Adolescent Psychologist
106H00000X
Marriage & Family Therapist

Other

Enumeration date
11/05/2018
Last updated
11/06/2019
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