Organization Active NPI

Change Lives Through Education LLC

  • Cognitive & Behavioral Psychologist
  • Collierville, TN
National Provider Identifier
1326559154
Registry record updated Oct 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
Legal business name
CHANGE LIVES THROUGH EDUCATION LLC
Doing business as
LearningRx Brain Training Center
Practice address
4680 Merchants Park Cir Ste 214
Collierville, TN 38017-9132
Phone
(901) 620-2150
NPI assigned
Oct 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2017

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

Authorized official

Name
Ms. Shervelle Demetria Thomas
Title
Executive Director
Phone
(901) 620-2150

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TB0200X Primary
Rehabilitation PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TR0400X
Rehabilitation PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 225400000X

Addresses

Primary practice location

4680 Merchants Park Cir Ste 214
Collierville, TN 38017-9132

Mailing address

7756 Antigua CV
Memphis, TN 38119-9154
Phone (901) 212-1950

Other names 1

  • LearningRx Brain Training Center Doing business as

National Provider Directory

National Provider Directory

Locations

4680 Merchants Park Cir
Ste 214
Collierville, TN 38017
Phone (901) 620-2150

NPI Registry JSON

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508371200000",
    "number": "1326559154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7756 ANTIGUA CV",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381199154",
            "telephone_number": "901-212-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4680 MERCHANTS PARK CIR STE 214",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380179132",
            "telephone_number": "901-620-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE LIVES THROUGH EDUCATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-19",
        "last_updated": "2017-10-19",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "SHERVELLE",
        "authorized_official_middle_name": "DEMETRIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "901-620-2150",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LearningRx Brain Training Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Collierville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; 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.