Change Behavioral Health, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CHANGE BEHAVIORAL HEALTH, INC

Doing business as

Change Behavioral Health, Inc.

Practice address

501 Sycamore St Ste 623
Waterloo, IA 50703-4651

Phone

(319) 233-0323

Fax

(319) 233-5923

NPI assigned

Apr 25, 2011

Last updated

Aug 16, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shannon Lee Harrington, BA, MA, MFT

Title

Chief Executove Officer

Phone

(319) 233-0323

Specialties & licenses 1

Addresses

Other names 1

• Change Behavioral Health, Inc. Doing business as

Locations

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

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313452800000",
    "number": "1093006017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 FALLS AVENUE SUITE 4",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507015700",
            "telephone_number": "319-233-0323",
            "fax_number": "319-233-5923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SYCAMORE ST STE 623",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507034651",
            "telephone_number": "319-233-0323",
            "fax_number": "319-233-5923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE BEHAVIORAL HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-25",
        "last_updated": "2011-08-16",
        "status": "A",
        "authorized_official_last_name": "HARRINGTON",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CHIEF EXECUTOVE OFFICER",
        "authorized_official_telephone_number": "319-233-0323",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BA, MA, MFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Change Behavioral Health, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sung Whoy Cha, MD
• Stephanie Chamberlin, RDH
• Gatbel Nyak Chamjock, PA
• Samir Chandra
• Change Behavioral Health
• Maria Isabel Chao-Shepard
• Wendy Lynn Chapin, ARNP
• Renee B Chapman, PTA
• Ashley Lynn Charmichael, DDS
• Sabina Mahmood Chatha

• Community/Behavioral Health Agency in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Community/Behavioral Health Agency in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.