NPIMap

Organization Active NPI

Be the Change in Mental Health

  • Adult Mental Health Clinic/Center
  • Santa Rosa, CA
National Provider Identifier
1508441403
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
BE THE CHANGE IN MENTAL HEALTH
Practice address
2800 Cleveland Ave Ste C
Santa Rosa, CA 95403-2784
Phone
(555) 555-5555
NPI assigned
Mar 11, 2021
Last updated
Feb 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Authorized official

Name
Michelle Kelley Crippen
Title
Director of Insurance/ Finances
Phone
(530) 680-2810

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

2800 Cleveland Ave Ste C
Santa Rosa, CA 95403-2784

Mailing address

2800 Cleveland Ave Ste a
Santa Rosa, CA 95403-2784

National Provider Directory

National Provider Directory

Locations

2800 Cleveland Ave
Ste A
Santa Rosa, CA 95403
Phone (281) 203-0063

2800 Cleveland Ave
Ste C
Santa Rosa, CA 95403
Phone (707) 800-7568

Practitioners & affiliated clinicians

Practitioners 4

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": "1615420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1508441403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 CLEVELAND AVE STE A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CLEVELAND AVE STE C",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032784",
            "telephone_number": "555-555-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BE THE CHANGE IN MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-11",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "CRIPPEN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "KELLEY",
        "authorized_official_title_or_position": "DIRECTOR OF INSURANCE/ FINANCES",
        "authorized_official_telephone_number": "530-680-2810"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.