Organization Active NPI

Changing Directions Counseling & Consulting, LLC

  • Clinical Social Worker
  • Alexandria, LA
National Provider Identifier
1881120459
Registry record updated Feb 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11031 Issued in LA
Legal business name
CHANGING DIRECTIONS COUNSELING & CONSULTING, LLC
Practice address
5920 Coliseum Blvd
Alexandria, LA 71303-3714
Phone
(318) 443-9339
NPI assigned
May 2, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2020

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

Authorized official

Name
Mrs. Traci D Miller-Earl, LCSW-BACSNPI 1558602698
Title
Owner
Phone
(936) 715-8293

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 11031 LA Primary

Addresses

Primary practice location

5920 Coliseum Blvd
Alexandria, LA 71303-3714

Mailing address

PO Box 2004
5019 Shreveport Hwy
Tioga, LA 71477-9998
Phone (936) 715-8293

Other practice location 1

5615 Jackson St Ste A
Alexandria, LA 71303-2326
Phone (318) 269-6675

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170608000012 LA Part B Supplier - Clinic/Group Practice 8820366263 Receives reassigned benefits from 1 practitioner
Practice locations: Alexandria, LA

National Provider Directory

National Provider Directory

Locations

4501 Jackson St
Ste C267
Alexandria, LA 71303
Phone (318) 269-6675

5615 Jackson St
#A
Alexandria, LA 71303
Phone (318) 269-6675

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": "1493683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581206400000",
    "number": "1881120459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2004",
            "address_2": "5019 SHREVEPORT HWY",
            "city": "TIOGA",
            "state": "LA",
            "postal_code": "714779998",
            "telephone_number": "936-715-8293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 COLISEUM BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033714",
            "telephone_number": "318-443-9339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5615 Jackson St Ste A",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "LA",
            "postal_code": "713032326",
            "country_code": "US",
            "telephone_number": "318-269-6675",
            "fax_number": "318-708-1013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHANGING DIRECTIONS COUNSELING & CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-02",
        "last_updated": "2020-02-09",
        "certification_date": "2020-02-09",
        "status": "A",
        "authorized_official_last_name": "MILLER-EARL",
        "authorized_official_first_name": "TRACI",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-715-8293",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW-BACS"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "11031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.