Az Center for Change

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

BH-3486 Issued in AZ

Legal business name

AZ CENTER FOR CHANGE

Practice address

4205 N 7TH Ave
311
Phoenix, AZ 85013-3078

Phone

(602) 253-8488

Fax

(602) 253-8340

NPI assigned

Dec 22, 2009

Organization subpart

No

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

Authorized official

Name

Diane Genco, MANPI 1962540583

Title

Clinical Director/Owner

Phone

(602) 253-8488

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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

• Diane Genco, MA

  • Mental Health Counselor
  • Phoenix, AZ
  • NPI 1962540583
  NPD (past) Authorized official
• Leann Charles, LPC

  • Professional Counselor
  • Phoenix, AZ
  • NPI 1306239843
  NPD (past)
• Jeri Gentry

  • Clinical Psychologist
  • Goodyear, AZ
  • NPI 1134470271
  NPD (past)
• Ellen M. Johnston, MA

  • Mental Health Counselor
  • Fayetteville, NC
  • NPI 1639436686
  NPD (past)

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1609105642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 N 7TH AVE",
            "address_2": "311",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133078",
            "telephone_number": "602-253-8488",
            "fax_number": "602-253-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 N 7TH AVE",
            "address_2": "311",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133078",
            "telephone_number": "602-253-8488",
            "fax_number": "602-253-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ CENTER FOR CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-22",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "GENCO",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "602-253-8488",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH-3486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Az Body Mechanics, PLLC
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• Az Camelback Business LLC
• Az Care Health Plan, Inc.
• Az Care Solutions Inc
• Az Children'S Dental Care PLLC
• Az Chiro Care, LLC
• Az Compassionate Care Behavioral & Wellness Clinic LLC
• Az Dental Specialty Group
• Az Dental, Inc

• Community/Behavioral Health Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.