Organization Active NPI

Optimal Change, PLLC

  • Clinical Social Worker
  • Quincy, IL
National Provider Identifier
1578134268
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
OPTIMAL CHANGE, PLLC
Practice address
3800 E Lake Ctr Ste 100C
Quincy, IL 62305-5839
Phone
(217) 740-2719
Fax
(877) 860-2719
NPI assigned
Jul 5, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Authorized official

Name
Kettisha Hodges, LCSWNPI 1235425620
Title
Behavioral Health Therapist
Phone
(573) 406-2473

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

3800 E Lake Ctr Ste 100C
Quincy, IL 62305-5839

Mailing address

3800 E Lake Ctr Ste 100C
Quincy, IL 62305-5839
Phone (217) 740-2719

Other practice location 1

2001 Maine St.
Suite 102
Quincy, IL 62301-4345
Phone (217) 740-2719

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address khodges@optimalchange21.org Direct
Direct Messaging Address khodges@optimalchange21.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211228002215 IL Part B Supplier - Clinic/Group Practice 7012308125 Receives reassigned benefits from 1 practitioner
Practice locations: Quincy, IL

National Provider Directory

National Provider Directory

Locations

2001 Maine St
Ste 102
Quincy, IL 62301
Phone (217) 740-2719

3800 E Lake Ctr
Ste 100C
Quincy, IL 62305
Phone (217) 740-2719

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": "1625443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775433600000",
    "number": "1578134268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 E LAKE CTR STE 100C",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623055839",
            "telephone_number": "217-740-2719",
            "fax_number": "877-860-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 E LAKE CTR STE 100C",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623055839",
            "telephone_number": "217-740-2719",
            "fax_number": "877-860-2719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Maine St.",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623014345",
            "country_code": "US",
            "telephone_number": "217-740-2719",
            "fax_number": "217-214-8005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OPTIMAL CHANGE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-05",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "KETTISHA",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "573-406-2473",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khodges@optimalchange21.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3800 E Lake Ctr Ste 100C",
            "city": "Quincy",
            "state": "IL",
            "country_code": "US",
            "postal_code": "623055839",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khodges@optimalchange21.org",
            "affiliation": "N",
            "address_1": "2001 Maine St.",
            "address_2": "Suite 102",
            "city": "Quincy",
            "state": "IL",
            "country_code": "US",
            "postal_code": "623014345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; 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.