Provider Demographics
NPI:1861385973
Name:CHOICES FOR CHANGE LLC
Entity type:Organization
Organization Name:CHOICES FOR CHANGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:484-532-8478
Mailing Address - Street 1:10871 BUSTLETON AVENUE PHILADELPHIA, PA, 191116
Mailing Address - Street 2:PMB #105
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116
Mailing Address - Country:US
Mailing Address - Phone:484-532-8478
Mailing Address - Fax:
Practice Address - Street 1:10939 HELMER DR # 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19154-4113
Practice Address - Country:US
Practice Address - Phone:484-532-8478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty