Organization · NPI-2

A Chance For Change LLC

Counselor, Addiction (Substance Use Disorder) · Norfolk, VA

NPI number1568094225

StatusActive

Last updated in NPPESAug 3, 2020

Details

NPI: 1568094225
Entity type: Organization (NPI-2)
Legal business name: A Chance For Change LLC
Organization subpart: No
Enumeration date: Feb 10, 2020
Certification date: Aug 3, 2020
Last updated: Aug 3, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
101YA0400X	Counselor, Addiction (Substance Use Disorder)	–	–	Yes
101YP2500X	Counselor, Professional	–	–
1041C0700X	Social Worker, Clinical	–	–
171M00000X	Case Manager/Care Coordinator	–	–
225C00000X	Rehabilitation Counselor	–	–
251S00000X	Community/Behavioral Health	–	–
261QR0401X	Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)	–	–
405300000X	Prevention Professional	–	–

Practice location

999 Waterside Dr Ste 2525
Norfolk, VA 23510-3316

Phone 757-777-3454 · Fax 757-568-7437

Mailing address

999 Waterside Dr Ste 2525
Norfolk, VA 23510-3316

Phone 757-777-3454 · Fax 757-568-7437

Authorized official

Amanda Colemon
Chief Executive Officer
9807459867

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