NPIMap

Organization Active NPI

Change Within Reach Inc

  • Adult Mental Health Clinic/Center
  • Encino, CA
National Provider Identifier
1003207002
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
LCSW28777 Issued in CA
Legal business name
CHANGE WITHIN REACH INC
Practice address
17777 Ventura Blvd Ste 105
Encino, CA 91316
Phone
(213) 445-2266
Fax
(213) 908-1233
NPI assigned
Feb 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Anna GershelisNPI 1285901942
Title
President
Phone
(213) 445-2266

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Adult Mental Health Clinic/Center 261QM0850X LCSW28777 CA Primary

Addresses

Primary practice location

17777 Ventura Blvd Ste 105
Encino, CA 91316

Mailing address

17777 Ventura Blvd Ste 105
Encino, CA 91316-3738
Phone (213) 445-2266

Other identifiers 1

IdentifierTypeStateIssuer
1285901942MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150619000776 CA Part B Supplier - Clinic/Group Practice 2062723810 Receives reassigned benefits from 27 practitioners
Practice locations: Encino, CA

National Provider Directory

National Provider Directory

Locations

17777 Ventura Blvd
Ste 105
Encino, CA 91316
Phone (213) 445-2266

1314 Westwood Blvd
Ste 201
Los Angeles, CA 90024
Phone (310) 475-0674

Practitioners & affiliated clinicians

Practitioners 55

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 55

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714089600000",
    "number": "1003207002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17777 VENTURA BLVD STE 105",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163738",
            "telephone_number": "213-445-2266",
            "fax_number": "213-908-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17777 VENTURA BLVD STE 105",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "91316",
            "telephone_number": "213-445-2266",
            "fax_number": "213-908-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE WITHIN REACH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-11",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A",
        "authorized_official_last_name": "GERSHELIS",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-445-2266",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CA",
            "license": "LCSW28777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285901942",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.