CHANGING GENERATIONAL LEGACIESLLC NPI 1598012155

NPI Information

  • NPI: 1598012155
  • Provider Name: CHANGING GENERATIONAL LEGACIES,LLC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Organization
  • Address: 1401 MERCANTILE LN
    SUITE 200-Q
    LARGO, MD
    ZIP 20774
  • Phone: (301) 322-4141

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NPI Details

CHANGING GENERATIONAL LEGACIES,LLC is a professional counselor in Largo, MD. CHANGING GENERATIONAL LEGACIES,LLC NPI is 1598012155. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1401 MERCANTILE LN
SUITE 200-Q
LARGO, MD
ZIP 20774-301
Phone: (301) 322-4141
Fax: (301) 322-9199

The provider's authorized official is Debra Joyce Johnson .
The authorized official title is Ceo, Founder and has the following contact phone number (301) 322-4141.

The enumeration date for this NPI number is 8/13/2012 and was last updated on 8/13/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessionalLC3809MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1040457800MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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