Edge of Change, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EDGE OF CHANGE, LLC

Practice address

116 State St Ste 203
Augusta, ME 04330-5632

Phone

(207) 592-9166

NPI assigned

Oct 18, 2022

Organization subpart

No

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

Authorized official

Name

Sara Fenwick, LCPC

Title

Owner

Phone

(207) 592-9166

Specialties & licenses 1

Addresses

Other names 1

• Sara Fenwick Other name

Locations

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1376269522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 STATE ST STE 203",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305632",
            "telephone_number": "207-592-9166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 STATE ST STE 203",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305632",
            "telephone_number": "207-592-9166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGE OF CHANGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "FENWICK",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-592-9166",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sara Fenwick",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Elizabeth Rose Earle, PHARMD
• Katie S Eastman, PHARMD
• Tiffany Ann Eaton, FNP
• Jenna E Ebert, PA-C
• James Lawrence Economou, LCSW
• Bryce Ashley Edwards, PHARMD, RPH
• Dawn Ego, LCSW
• Felix Temitope Elijah
• Allyson Eller
• Katelyn Grace Ellis, OTR/L

• Mental Health Clinic/Center (Including Community Mental Health Center) in Augusta, ME
• Providers in Augusta, ME by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.