Provider Demographics
NPI:1043016751
Name:LASTING CHANGES, LLC
Entity type:Organization
Organization Name:LASTING CHANGES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:LYND
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:503-881-9912
Mailing Address - Street 1:152 WILDWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PITMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08071-1543
Mailing Address - Country:US
Mailing Address - Phone:503-881-9912
Mailing Address - Fax:
Practice Address - Street 1:152 WILDWOOD AVE
Practice Address - Street 2:
Practice Address - City:PITMAN
Practice Address - State:NJ
Practice Address - Zip Code:08071-1543
Practice Address - Country:US
Practice Address - Phone:503-881-9912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-22
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty