Changing Tides Child and Family Enrichment Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

447 Issued in AK

Legal business name

CHANGING TIDES CHILD AND FAMILY ENRICHMENT CENTER

Doing business as

Changing Tides

Practice address

2600 Denali St Ste 606
Anchorage, AK 99503-2754

Phone

(907) 903-7880

NPI assigned

Jun 8, 2016

Last updated

Jun 8, 2016By 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

Mrs. Kimber Raye Olson, LCSW

Title

Owner/Clinical Director

Phone

(907) 903-7880

Specialties & licenses 1

Addresses

Other names 1

• Changing Tides Doing business as

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465344000000",
    "number": "1467801548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 DENALI ST STE 606",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032754",
            "telephone_number": "907-903-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 DENALI ST STE 606",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032754",
            "telephone_number": "907-903-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING TIDES CHILD AND FAMILY ENRICHMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-08",
        "last_updated": "2016-06-08",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "KIMBER",
        "authorized_official_middle_name": "RAYE",
        "authorized_official_title_or_position": "OWNER/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "907-903-7880",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AK",
            "license": "447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Changing Tides",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deanna Shandon Chaney, LCSW
• Eugene M Chang, M.D.
• Kenneth Yk Chang
• Changes West, LLC
• Changing Faces Inc.
• Juan Chapa, MS, CDC I
• Amanda Chapman
• Caitlin Nicole Chapman, R.D.
• Henry Allen Chapman, PA-C
• Holly Jean Chapman, M.D.

• Community/Behavioral Health Agency in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Community/Behavioral Health Agency in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.