Indelible Changes Llc
Adolescent and Children Mental Health Clinic/Center in Woodbridge, Virginia
NPI 1720540107
Indelible Changes Llc is an Adolescent and Children Mental Health Clinic/Center based in Dumfries, VA and is specialized in Adolescent and Children Mental Health. Indelible Changes Llc practices in Woodbridge, VA. The NPI Number for Indelible Changes Llc is 1720540107 and holds a License No. (Virginia).
The current practice location address for Indelible Changes Llc is 12890 Harbor Dr, Woodbridge, VA and can be reached out via phone at 570-316-1020. You can also correspond with Indelible Changes Llc through the mailing address at 4191 WATERWAY DR, DUMFRIES, VA - 22025-1602 (mailing address contact number: 703-474-0585).
Location: 12890 Harbor Dr, Woodbridge, VA, 22025-1602
Provider Profile Details
NPI Number
1720540107
Provider Name
Indelible Changes Llc
Credential
Provider Entity Type
Organization
Address
12890 Harbor Dr, Woodbridge, VA, 22025-1602
Phone Number
570-316-1020
Fax Number
Provider Enumeration Date
04/03/2019
Last Update Date
03/13/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 575326118 | 05 | VA |
Provider Business Practice Location Address Details
Address
12890 Harbor Dr
City
State
Zip
22192-2921
Phone Number
570-316-1020
Fax Number
Provider Business Mailing Address Details
Address
4191 Waterway Dr
City
State
Zip
22025-1602
Phone Number
703-474-0585
Fax Number
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
-
Taxonomy
License No.
()
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Provider's Taxonomy Details 4
Type
Behavioral Health & Social Service Providers
Classification
Social Worker
Speciality
-
Taxonomy
License No.
()
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
Provider's Taxonomy Details 5
Type
Behavioral Health & Social Service Providers
Classification
Social Worker
Speciality
Clinical
Taxonomy
License No.
()
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Provider's Taxonomy Details 6
Type
Behavioral Health & Social Service Providers
Classification
Marriage & Family Therapist
Speciality
-
Taxonomy
License No.
()
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
Provider's Taxonomy Details 7
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
License No.
()
Definition
Definition to come...
Provider's Taxonomy Details 8
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
Provider's Taxonomy Details 9
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
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