Organization Active NPI

Time for Change

  • Community/Behavioral Health Agency
  • District Heights, MD
National Provider Identifier
1518319573
Registry record updated Jul 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
PRC14577 Issued in DC
Legal business name
TIME FOR CHANGE
Practice address
1651 Tulip Ave
District Heights, MD 20747-2622
Phone
(202) 403-9206
NPI assigned
Jul 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2016

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

Authorized official

Name
Mrs. Tonya Ridley, LPC CRCNPI 1164875266
Title
Ceo
Phone
(202) 768-8454

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
Community/Behavioral Health Agency 251S00000X PRC14577 DC Primary

Addresses

Primary practice location

1651 Tulip Ave
District Heights, MD 20747-2622

Mailing address

1929 Valley Ter SE
Washington, DC 20032-4627
Phone (202) 768-8454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190215001397 DC Part B Supplier - Clinic/Group Practice 2769720887 Receives reassigned benefits from 1 practitioner
Practice locations: Washington, DC

National Provider Directory

National Provider Directory

Locations

101 Xenia St SW
Ste 200
Washington, DC 20032
Phone (202) 703-0223

Practitioners & affiliated clinicians

Practitioners 1

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": "1467331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467331200000",
    "number": "1518319573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1929 VALLEY TER SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200324627",
            "telephone_number": "202-768-8454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 TULIP AVE",
            "city": "DISTRICT HEIGHTS",
            "state": "MD",
            "postal_code": "207472622",
            "telephone_number": "202-403-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIME FOR CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-01",
        "last_updated": "2016-07-01",
        "status": "A",
        "authorized_official_last_name": "RIDLEY",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-768-8454",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC CRC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "DC",
            "license": "PRC14577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in District Heights, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.