NPIMap

Organization Active NPI

Life Changes, LLC

  • Mental Health Counselor
  • Lake Mary, FL
National Provider Identifier
1245829787
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LIFE CHANGES, LLC
Practice address
255 Primera Blvd Ste 160
Lake Mary, FL 32746-2168
Phone
(407) 376-0991
Fax
(321) 234-8272
NPI assigned
Jan 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Kimberley Lee Walker, LMHC, NCCNPI 1629012893
Title
Owner/Provider
Phone
(407) 376-0991

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

255 Primera Blvd Ste 160
Lake Mary, FL 32746-2168

Mailing address

9300 Conroy Windermere Rd # 3341
Windermere, FL 34786-9997
Phone (407) 376-0991

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Kimberley.Walker@LifeChangesLLC.hush.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Life Changes LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9300 Conroy Windermere Rd
Unit 3341
Windermere, FL 34786

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1245829787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 CONROY WINDERMERE RD # 3341",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347869997",
            "telephone_number": "407-376-0991",
            "fax_number": "321-234-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 PRIMERA BLVD STE 160",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462168",
            "telephone_number": "407-376-0991",
            "fax_number": "321-234-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHANGES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KIMBERLEY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "407-376-0991",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMHC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kimberley.Walker@LifeChangesLLC.hush.com",
            "affiliation": "N",
            "endpointDescription": "HIPPA compliant email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "255 Primera Blvd Ste 160",
            "city": "Lake Mary",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327462168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.