Moment of Change Counseling Services, PLLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MOMENT OF CHANGE COUNSELING SERVICES, PLLC

Practice address

106 Wortham CT
Henderson, NC 27537-4500

Phone

(252) 320-9903

Fax

(252) 203-4050

NPI assigned

Apr 24, 2020

Organization subpart

No

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

Authorized official

Name

Jamie Washington, LCMHC, LCASNPI 1366954356

Title

Director

Phone

(252) 320-9903

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 4

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

• Jamie Lee Washington, LCMHC, LCAS

  • Professional Counselor
  • Durham, NC
  • NPI 1366954356

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD Authorized official
• Solana Ramonita Sparks

  • Professional Counselor
  • Raleigh, NC
  • NPI 1013563246
  Medicare reassignment NPD
• Ayauna Sumpter, MSW, LCSWA

  • Clinical Social Worker
  • Raleigh, NC
  • NPI 1679172811
  Medicare reassignment NPD
• Diana Bracey

  • Clinical Social Worker
  • Henderson, NC
  • NPI 1811619844
  NPD

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

{
    "created_epoch": "1587686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1972123487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 WORTHAM CT",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275374500",
            "telephone_number": "252-320-9903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 WORTHAM CT",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275374500",
            "telephone_number": "252-320-9903",
            "fax_number": "252-203-4050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "943 W Andrews Ave Ste P",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NC",
            "postal_code": "275362587",
            "country_code": "US",
            "telephone_number": "252-320-9903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOMENT OF CHANGE COUNSELING SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-24",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "252-320-9903",
        "authorized_official_credential": "LCMHC, LCAS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6103107",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitney Melton Evans
• Deanne Michael, PA-C
• Karen Jill Miller, LCSWA
• Mindfully at Peace
• Mohamed & Foulkes DDS PA
• Monae'S Home Care Agency, LLC
• Frances Hayden Mulligan
• Munther S Tabet MD PA
• Hallie Rachel Murchison, PA-C
• Josphat S. Musapatike, MD

• Community/Behavioral Health Agency in Henderson, NC
• Providers in Henderson, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.