Organization
CHANGING LIVES THERAPEUTIC SERVICE, LLC
Active
Other names
CHANGING LIVES THERAPEUTIC SERVICE,LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CEMETRIUS ROLLE LCSW (CO-OWNER)
(980) 833-1121
Entity
Organization
Contact information
Practice address
413 MOUNT CROSS RD STE 102, DANVILLE, VA 24540-4089
(888) 388-8726
Mailing address
8825 UNIVERSITY EAST DR STE 200, CHARLOTTE, NC 28213-4395
(980) 833-1121
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
175T00000X
Peer Specialist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295117760
—
NC
05
—
1922582998
—
NC
Enumeration date
05/14/2020
Last updated
03/24/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us