Active NPI
Change Lives Through Education LLC
- Cognitive & Behavioral Psychologist
- Collierville, TN
National Provider Identifier
1326559154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | Primary | ||
| Rehabilitation Psychologist | 103TR0400X | |||
| Rehabilitation Practitioner | 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
National Provider Directory
National Provider DirectoryLocations
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.