SEA CHANGE THERAPY PLLC (NPI# 1790215986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790215986 |
| Entity Type | Organization |
| Organization Name | SEA CHANGE THERAPY PLLC |
| Practice Address |
3308 Ash Vw Williamsburg VA 23185 |
| Mailing Address |
3308 Ash Vw Williamsburg VA 23185-8101 |
| Practice Telephone | 2524357747 |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2019-03-06 |
| Authorized Official Name | ASHLEY C OVERMAN-GOLDSMITH (OWNER/CEO) |
| Authorized Official Telephone | 2524357747 |
| Authorized Official Credential | MA LPC NCC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
NC | Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 722 Parkham Ln, Raleigh, NC 27603 | 2524357747 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Sea Change Therapy PLLC | 2231 Cloud Cover Lane, Raleigh, NC 27614 |
| Street Address |
3308 ASH VW |
| City | WILLIAMSBURG |
| State | VA |
| Zip Code | 23185 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215579412 | Marian Shearin | Technician | 112 Indian Circle, Williamsburg, VA 23185 | 2019-10-09 |
| 1093363251 | 1st Choice In-homecare, Inc. | Durable Medical Equipment & Medical Supplies | 161-a John Jefferson Road Ste 101, Williamsburg, VA 23185 | 2019-08-30 |
| 1265939482 | Michelle Antionette Hill | Counselor | 1769 Jamestown Rd Ste 107, Williamsburg, VA 23185 | 2018-04-13 |
| 1114437480 | Kimberly Anne Allan | Orthotic Fitter | 1811 Jamestown Rd., Williamsburg, VA 23185 | 2017-10-02 |
| 1881115590 | Shawn Patrick Mcnulty | Counselor | Colonial Behavioral Health, 1657 Merrimac Trail, Williamsburg, VA 23185 | 2017-07-03 |
| 1316479322 | Maureen Bounds | Pharmacist | 230 Gooch Dr, Williamsburg, VA 23185 | 2017-03-29 |
| 1386196970 | Joshua Desilva | Psychologist | 240 Gooch Drive, 2nd Floor, Williamsburg, VA 23185 | 2016-10-29 |
| 1750837001 | Ellen Lerose | Pharmacist | 5601-b Richmond Road, Williamsburg, VA 23185 | 2016-08-28 |
| 1194173922 | Michael C. Shuck, Dds PC | Dentist | 1480 Quarterpath Rd, Ste 2a, Williamsburg, VA 23185 | 2016-06-02 |
| 1700285723 | Jana Brultz | Counselor | 215 Mclaws Circle, Suite 1, Williamsburg, VA 23185 | 2014-08-14 |
| Find all providers in zip 23185 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1477165926 | Annalucia Bays, LLC | Clinic/Center | 240 Gooch Drive, Mcleod Tyler Wellness Center, Williamsburg, VA 23185 | 2020-08-17 |
| 1457906810 | Pamela Thompson Lpc LLC | Clinic/Center | 4732 Longhill Rd Ste 3202, Williamsburg, VA 23188-1586 | 2019-08-02 |
| 1720551963 | White Cloud Therapeutic Services, LLC | Clinic/Center | 322 Monticello Ave, Williamsburg, VA 23185-2834 | 2019-01-10 |
| 1932678265 | Williamsburg Counseling and Wellness Center, LLC | Clinic/Center | 1101 Professional Dr, Williamsburg, VA 23185-3301 | 2018-11-15 |
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| Find all providers with the same taxonomy | ||||
| City | WILLIAMSBURG |
| Zip Code | 23185 |
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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.