Life Changes Counseling and Consultant Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

LIFE CHANGES COUNSELING AND CONSULTANT SERVICES, LLC

Practice address

1003 Virginia Ave Ste 104
Atlanta, GA 30354-1366

Phone

(404) 500-1994

NPI assigned

Aug 13, 2020

Organization subpart

No

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

Authorized official

Name

Terence Wilkins, LPC, MAC

Title

Ceo

Phone

(609) 743-1773

Specialties & licenses 3

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597276800000",
    "number": "1407467434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 VIRGINIA AVE STE 104",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303541366",
            "telephone_number": "404-500-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 VIRGINIA AVE STE 104",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303541366",
            "telephone_number": "404-500-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHANGES COUNSELING AND CONSULTANT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A",
        "authorized_official_last_name": "WILKINS",
        "authorized_official_first_name": "TERENCE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-743-1773",
        "authorized_official_credential": "LPC, MAC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.