Organization
MOMENT OF CHANGE COUNSELING SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE WASHINGTON LCMHC, LCAS (DIRECTOR)
(252) 320-9903
Entity
Organization
Contact information
Practice address
106 WORTHAM CT, HENDERSON, NC 27537-4500
(252) 320-9903
(252) 203-4050
Mailing address
106 WORTHAM CT, HENDERSON, NC 27537-4500
(252) 320-9903
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103107
—
NC
Enumeration date
04/24/2020
Last updated
01/09/2023
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