NPIMap

Organization Active NPI

New Changes LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • De Pere, WI
National Provider Identifier
1356190904
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
NEW CHANGES LLC
Doing business as
NEW Changes LLC
Practice address
3311 Packerland Dr Ste a
#19
De Pere, WI 54115-9539
Phone
(920) 530-4433
Fax
(920) 688-4261
NPI assigned
May 16, 2024
Last updated
May 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Authorized official

Name
Ms. Bobbie Jo L Bleser, LPC, CSACNPI 1255640033
Title
Owner/Psychotherapist
Phone
(920) 530-4433

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

3311 Packerland Dr Ste a
#19
De Pere, WI 54115-9539

Mailing address

2373 Yolanda Cir
Green Bay, WI 54303-6202
Phone (920) 676-6447

Other identifiers 1

IdentifierTypeStateIssuer
100021415MedicaidWI

Other names 1

  • NEW Changes LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
New Changes LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1356190904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2373 YOLANDA CIR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543036202",
            "telephone_number": "920-676-6447",
            "fax_number": "920-688-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 PACKERLAND DR STE A",
            "address_2": "#19",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159539",
            "telephone_number": "920-530-4433",
            "fax_number": "920-688-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW CHANGES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "BLESER",
        "authorized_official_first_name": "BOBBIE JO",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "920-530-4433",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC, CSAC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100021415",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEW Changes LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in De Pere, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.