Changing Lanes Intervention Human Services

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

CHANGING LANES INTERVENTION HUMAN SERVICES

Practice address

500 Lanier Ave W Ste 608
Fayetteville, GA 30214-7644

Phone

(770) 580-4116

Fax

(888) 522-1055

NPI assigned

May 27, 2022

Organization subpart

No

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

Authorized official

Name

Ashley Martin, LPC,LBA,BCBA,CRPSNPI 1740785310

Title

Chief Executive Officer

Phone

(770) 580-4116

Specialties & licenses 4

Addresses

Electronic endpoints 2

Locations

Practitioners 1

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

• Ashley Martin, LPC,BCBA,LBA, CMAC,

  • Professional Counselor
  • Fayetteville, GA
  • NPI 1740785310
  NPD Authorized official

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

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1528707643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LANIER AVE W STE 608",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147644",
            "telephone_number": "770-256-3977",
            "fax_number": "888-522-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LANIER AVE W STE 608",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147644",
            "telephone_number": "770-580-4116",
            "fax_number": "888-522-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING LANES INTERVENTION HUMAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-27",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "770-580-4116",
        "authorized_official_credential": "LPC,LBA,BCBA,CRPS"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@clihumanservices.com",
            "affiliation": "N",
            "endpointDescription": "EMAIL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ICANOTES",
            "address_1": "500 Lanier Ave W Ste 608",
            "city": "Fayetteville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302147644",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "changinglanesinterventionhumanservices.hbportal.co/app/",
            "affiliation": "N",
            "endpointDescription": "Appointments",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Client Portal",
            "address_1": "500 Lanier Ave W Ste 608",
            "city": "Fayetteville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302147644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Professional Counselor in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Professional Counselor in Georgia

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