Provider Demographics
NPI:1679326482
Name:CHANGE OF HEART COUNSELING & EQUINE ASSISTED THERAPY LLC
Entity type:Organization
Organization Name:CHANGE OF HEART COUNSELING & EQUINE ASSISTED THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWANDA
Authorized Official - Middle Name:LINDSEY
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-251-2983
Mailing Address - Street 1:5435 DAIRY LN
Mailing Address - Street 2:
Mailing Address - City:TODD
Mailing Address - State:PA
Mailing Address - Zip Code:16685-8501
Mailing Address - Country:US
Mailing Address - Phone:814-448-2262
Mailing Address - Fax:
Practice Address - Street 1:5435 DAIRY LN
Practice Address - Street 2:
Practice Address - City:TODD
Practice Address - State:PA
Practice Address - Zip Code:16685-8501
Practice Address - Country:US
Practice Address - Phone:814-251-2983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty