A CHANCE FOR CHANGE LLC (NPI# 1568094225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568094225 |
| Entity Type | Organization |
| Organization Name | A CHANCE FOR CHANGE LLC |
| Practice Address |
999 Waterside Dr Ste 2525 Norfolk VA 23510-3316 |
| Practice Telephone | 7577773454 |
| Practice Fax Number | 7575687437 |
| Mailing Telephone | 7577773454 |
| Mailing Fax Number | 7575687437 |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-08-03 |
| Authorized Official Name | MS. AMANDA COLEMON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9807459867 |
| Authorized Official Credential | BA, PSYCHOLOGY, |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers | ||
| N | 225C00000X | Rehabilitation Counselor | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Ambulatory Health Care Facilities | ||
| N | 405300000X | Prevention Professional | Other Service Providers | ||
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1417573189 | 05 | |
| VA | 1427603182 | 05 | |
| VA | 1609289479 | 05 |
| Street Address |
999 WATERSIDE DR STE 2525 |
| City | NORFOLK |
| State | VA |
| Zip Code | 23510-3316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235506387 | Jason Charles Evers | Family Medicine | 999 Waterside Dr Ste 2525, Norfolk, VA 23510-3316 | 2015-08-25 |
| 1881293421 | Jamar Humphrey | Driver | 999 Waterside Dr Ste 2525, Norfolk, VA 23510-3316 | 2020-10-24 |
| 1255945739 | Bluestone Physician Services Southeast LLC | General Practice | 999 Waterside Dr Ste 2525, Norfolk, VA 23510-3316 | 2020-09-02 |
| 1194336313 | Lifephysician, LLC | Clinic/Center | 999 Waterside Dr Ste 2525, Norfolk, VA 23510-3316 | 2020-08-11 |
| 1417573189 | Katina Dickson | Counselor | 999 Waterside Dr Ste 2525, Norfolk, VA 23510-3316 | 2020-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972151108 | Brittany Delong | Speech-Language Pathologist | 534 E Olney Road, Norfolk, VA 23510 | 2019-08-30 |
| 1881164366 | Gregory D Newman | Hearing Instrument Specialist | 501 B Bousch St, Norfolk, VA 23510 | 2018-11-28 |
| 1598282998 | Tidewater Hyperbaric | Preventive Medicine | 129 West Virginia Beach Blvd, Suite 140 A, Norfolk, VA 23510 | 2017-08-25 |
| 1295276186 | John Michael Curnes | General Practice | 200 College Pl Apt 215, Norfolk, VA 23510 | 2017-03-13 |
| 1326499989 | East Coast Family Services | Community/Behavioral Health | 259 Granby St., Norfolk, VA 23510 | 2016-06-24 |
| 1659750529 | Cortney Armitano | Specialist/Technologist | 201 West Tazewell Street, Apt. 206, Norfolk, VA 23510 | 2015-05-26 |
| 1285076067 | Abundant Life Therapeutic Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 645 Church St., Suite 104c, Norfolk, VA 23510 | 2013-07-22 |
| 1497196901 | Patricia Ann Richardson | Assisted Living Facility | 101 East Plume Street, 501, Norfolk, VA 23510 | 2013-07-12 |
| 1427319300 | The Foleck Center | Dentist | 201 College Place, #111, Norfolk, VA 23510 | 2012-06-06 |
| 1033414941 | Laura Jeanne O'neal | Social Worker | 250 W Brambleton Ave, Ste 101, Norfolk, VA 23510 | 2011-01-24 |
| Find all providers in zip 23510 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154885366 | Transforming Hearts, LLC | Counselor | 900 Granby St Ste 242, Norfolk, VA 23510-2503 | 2019-01-22 |
| 1407331135 | Demeitrius M Whitehurst | Counselor | 12388 Warwick Blvd Ste 302, Newport News, Va 23602, Ste 302, Norfolk, VA 23606-2360 | 2018-09-27 |
| 1114449162 | Second Start, LLC | Counselor | 1432 Baychester Ave Apt A4, Norfolk, VA 23503-2320 | 2017-07-12 |
| 1760807754 | Sara Heller | Counselor | 39 Grant St, Norfolk, CT 06058-1327 | 2014-02-27 |
| 1942634977 | Elizabeth Nicole Snow | Counselor | 6325 N Center Dr Ste 202, Norfolk, VA 23502-0019 | 2013-08-27 |
| 1255689527 | Andrea Danette Sutton | Counselor | 402 E Little Creek Rd, Norfolk, VA 23505-2714 | 2012-08-16 |
| 1609137108 | Kelly M Higgins | Counselor | 9515 Dulwich Cres, Norfolk, VA 23503-2850 | 2012-06-01 |
| 1386951499 | Stacy Richardson | Counselor | 521 Park Cres, Norfolk, VA 23511-4009 | 2010-09-10 |
| 1639342884 | Donald E Edwards | Counselor | 1001 W Norfolk Ave, Norfolk, NE 68701-5057 | 2008-04-09 |
| 1073707410 | Janice Gray | Counselor | 110 Kingsley Ln Ste 206, Norfolk, VA 23505-4616 | 2007-08-29 |
| Find all providers in NORFOLK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.