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Modern Change Pllc
Mental Health Clinic/Center (Including Community Mental Health Center) in Durham, North Carolina
NPI 1790311207

Modern Change Pllc is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Durham, NC and is specialized in Mental Health (Including Community Mental Health Center). Modern Change Pllc practices in Durham, NC. The NPI Number for Modern Change Pllc is 1790311207 and holds a License No. (North Carolina).

The current practice location address for Modern Change Pllc is 5316 Highgate Dr Ste 221, Durham, NC and can be reached out via phone at 919-605-5197 and via fax at 919-797-9922.

Location: 5316 Highgate Dr Ste 221, Durham, NC, 27713-6629
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1790311207
Provider Name
Modern Change Pllc
Credential
Provider Entity Type
Organization
Address
5316 Highgate Dr Ste 221, Durham, NC, 27713-6629
Phone Number
919-605-5197
Fax Number
919-797-9922
Provider Enumeration Date
03/16/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1295187763 01 NPI
institution
Provider Business Practice Location Address Details
Address
5316 Highgate Dr Ste 221
City
Durham
State
North Carolina
Zip
27713-6629
Phone Number
919-605-5197
Fax Number
919-797-9922
person
Provider Business Mailing Address Details
Address
5316 Highgate Dr Ste 221
City
Durham
State
North Carolina
Zip
27713-6629
Phone Number
919-605-5197
Fax Number
919-797-9922
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
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.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
()
Definition
Definition to come...
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