Changing Lives Wellness LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

CHANGING LIVES WELLNESS LLC

Practice address

625 Kenmoor Ave SE # 150434
Grand Rapids, MI 49546-2395

Phone

(248) 413-5013

NPI assigned

Apr 9, 2026

Last updated

Apr 9, 2026By 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

Brian Mangenje, FNP-BC, PMHNP-BC/CNPI 1134873524

Title

Owner / NP / Provider

Phone

(248) 413-5013

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian Mangenje, FNP-BC

  • Family Nurse Practitioner
  • Detroit, MI
  • NPI 1134873524
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1775692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775692800000",
    "number": "1144162835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 KENMOOR AVE SE # 150434",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462395",
            "telephone_number": "248-413-5013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 KENMOOR AVE SE # 150434",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462395",
            "telephone_number": "248-413-5013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING LIVES WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-09",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A",
        "authorized_official_last_name": "MANGENJE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER / NP / PROVIDER",
        "authorized_official_telephone_number": "248-413-5013",
        "authorized_official_credential": "FNP-BC, PMHNP-BC/C"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoe Nikole Chandler
• Leela Chandrasekar, MD
• Aaron Sung-En Chang
• Meghan Haley Chang
• Susan Chang, LMSW
• Changing Seasons Therapy PLLC
• Channeling Change Counseling PLLC
• Madison P Chapel, RN
• Audrie Chapin, LMSW
• Nicholas Constable Chapin

• Psychiatric/Mental Health Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.