Organization
CHANGE IN MOTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LANICIA CAIN (OWNER)
(407) 575-9102
Entity
Organization
Contact information
Practice address
1850 LEE RD STE 322, WINTER PARK, FL 32789-2107
(407) 637-2633
(407) 558-3438
Mailing address
1850 LEE RD STE 322, WINTER PARK, FL 32789-2107
(407) 637-2633
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
IMH15376
FL
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101840100
—
FL
Enumeration date
10/09/2015
Last updated
04/05/2021
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