Modern Change Pllc

LBN: Modern Change Pllc
Modern Change Pllc is an health care organization with primary practice located at 5720 Fayetteville Rd Ste 202 , Durham NC 27713-5333. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center). Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. Modern Change Pllc can be contacted via phone (919) 576-0084, or through Porter, Monique via phone (919) 576-0084.

Contact Information

Primary practice address
5720 Fayetteville Rd Ste 202 Durham NC 27713-5333
Phone: (919) 576-0084
Fax: (919) 797-9922
Website:
Map and Directions
Authorized official contact:
Name: Porter, Monique LCMHC, LCAS
Phone: (919) 576-0084

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X

Profile Details

NPI number 1790311207
LBN Legal business name Modern Change Pllc
DBA Doing business as
Authorized official Porter, Monique LCMHC, LCAS
Entity Organization
Organization subpart 1 No
Enumeration date Mar 16th, 2020
Last updated Apr 18th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790311207 NPPES
Other 1295187763 NPI

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