Roads of Change Counseling, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ROADS OF CHANGE COUNSELING, LLC

Practice address

2708 Cleveland Rd Ste 200
Wooster, OH 44691-1703

Phone

(234) 249-2189

NPI assigned

May 6, 2024

Last updated

Oct 15, 2024By 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

Lisa Kelly, LISW-SNPI 1437598182

Title

Owner/Ceo

Phone

(234) 249-2189

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

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.

• Lisa M. Kelly, MSW, LSW

  • Clinical Social Worker
  • Wooster, OH
  • NPI 1437598182
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1639926603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 E SMITHVILLE WESTERN RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911038",
            "telephone_number": "330-635-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 CLEVELAND RD STE 200",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911703",
            "telephone_number": "234-249-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROADS OF CHANGE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "234-249-2189",
        "authorized_official_credential": "LISW-S"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Wooster, OH
• Providers in Wooster, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.