Organization Active NPI

Changing How I Live Life

  • Addiction (Substance Use Disorder) Counselor
  • Austin, TX
National Provider Identifier
1487977583
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
CHANGING HOW I LIVE LIFE
Practice address
1006 E Yager LN
A 104
Austin, TX 78753-7088
Phone
(512) 385-4799
NPI assigned
Mar 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Authorized official

Name
Miss Lori D. Wilson, LCDCNPI 1114473592
Title
Executive Director
Phone
(512) 385-4799

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X TX Primary
Case Management Agency 251B00000X
Developmentally Disabled Services Day Training Agency 251C00000X
In Home Supportive Care Agency 253Z00000X
In Home Supportive Care Agency 253Z00000X 5006 TX

Addresses

Primary practice location

1006 E Yager LN
A 104
Austin, TX 78753-7088

Mailing address

1006 E. Yager Lane
A 104
Austin, TX 78753
Phone (512) 385-4799

Other identifiers 1

IdentifierTypeStateIssuer
065483201MedicaidTX

National Provider Directory

National Provider Directory

Locations

1006 E Yager Ln
Ste 104A
Austin, TX 78753
Phone (512) 385-4799

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473811200000",
    "number": "1487977583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 E. YAGER LANE",
            "address_2": "A 104",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78753",
            "telephone_number": "512-385-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 E YAGER LN",
            "address_2": "A 104",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787537088",
            "telephone_number": "512-385-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING HOW I LIVE LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-04",
        "last_updated": "2016-09-14",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "512-385-4799",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LCDC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "TX",
            "license": "5006",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065483201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.