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Organization

EMOTIONAL CHANGE INC.

Active
Other names
Lascano Professional Services
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY GEORGE MFT (CEO)
(314) 974-7347
Entity
Organization

Contact information

Practice address
4368 EAGLE ROCK BLVD, LOS ANGELES, CA 90041-3211
(314) 974-7347
(314) 843-0201
Mailing address
4368 EAGLE ROCK BLVD, LOS ANGELES, CA 90041-3211
(314) 974-7347
(314) 843-0201

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
103G00000X
Clinical Neuropsychologist
103TC0700X
Clinical Psychologist
Primary
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
2084P0800X
Psychiatry Physician
2084P0802X
Addiction Psychiatry Physician
2084P0804X
Child & Adolescent Psychiatry Physician
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist

Other

Enumeration date
05/31/2012
Last updated
05/31/2012
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