Organization Active NPI

Changesu

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dunedin, FL
National Provider Identifier
1578072039
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
IMH1215 Issued in FL
Legal business name
CHANGESU
Practice address
998 Emerson Drive
Dunedin, FL 34698
Phone
(727) 422-5659
Fax
(727) 279-4944
NPI assigned
Sep 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. Diana Saum Herring, LMHCNPI 1043587959
Title
Owner
Phone
(727) 422-5659

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X IMH1215 FL Primary

Addresses

Primary practice location

998 Emerson Drive
Dunedin, FL 34698

Mailing address

998 Emerson Dr
Dunedin, FL 34698-6039
Phone (727) 422-5659

Other identifiers 1

IdentifierTypeStateIssuer
1043587959MedicaidFL

National Provider Directory

National Provider Directory

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": "1506470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1578072039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 EMERSON DR",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346986039",
            "telephone_number": "727-422-5659",
            "fax_number": "727-279-4944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 EMERSON DRIVE",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "34698",
            "telephone_number": "727-422-5659",
            "fax_number": "727-279-4944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGESU",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HERRING",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "SAUM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-422-5659",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "FL",
            "license": "IMH1215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043587959",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunedin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.