Road to Change

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

ROAD TO CHANGE

Practice address

2620 Centenary Blvd Ste 204
Shreveport, LA 71104-3350

Phone

(318) 470-7730

NPI assigned

Oct 31, 2018

Last updated

Oct 31, 2018By 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

Dana L ConverseNPI 1871966671

Title

Owner

Phone

(318) 470-7730

Specialties & licenses 1

Addresses

Tax ID family

Road to Change2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Road to Change

  • Professional Counselor
  • Shreveport, LA
  • NPI 1801504279
  NPD tax ID

Locations

Practitioners 1

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.

• Dana Converse, MA, LPC

  • Professional Counselor
  • Shreveport, LA
  • NPI 1871966671
  NPD Authorized official

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540944000000",
    "number": "1518434182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9019 TOPLECOT DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711295137",
            "telephone_number": "318-470-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 CENTENARY BLVD STE 204",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711043350",
            "telephone_number": "318-470-7730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROAD TO CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-31",
        "last_updated": "2018-10-31",
        "status": "A",
        "authorized_official_last_name": "CONVERSE",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-470-7730"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• River Cities Dental Sleep Medicine Corporation
• Holly Rivers, NP
• Mildred Rivers
• Terri Lane Rivers, M.C.D. CCC-SLP
• Bailey Rivet
• Road to Change
• Road to Change Residential
• Road2Success LLC
• Road2Success LLC
• Roan Counseling, LLC

• Professional Counselor in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Professional Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; 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.