Life Changers Intervention Services LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

LIFE CHANGERS INTERVENTION SERVICES LLC

Practice address

5039 Main St Suite 2
Shallotte, NC 28470

Phone

(910) 754-7988

NPI assigned

Oct 10, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Beverly Stanley

Title

Owner/Executive Director

Phone

(910) 754-7988

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556064000000",
    "number": "1356539795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5039 MAIN ST SUITE 2",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "28470",
            "telephone_number": "910-754-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5039 MAIN ST SUITE 2",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "28470",
            "telephone_number": "910-754-7988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHANGERS INTERVENTION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2019-04-24",
        "status": "A",
        "authorized_official_last_name": "STANLEY",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "OWNER/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "910-754-7988",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sarah-Ann Livingston
• Kelleyanne Helene Lonergan
• Corey Elizabeth Burr Long, OD
• Emma Long, LCSWA, LCASA

• Case Management Agency in Shallotte, NC
• Providers in Shallotte, NC by specialty
• Case Management Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.