Change, Inc

Primary specialty

Social WorkerTaxonomy code 104100000X

License

3737 Issued in CT

Legal business name

CHANGE, INC

Practice address

1251 S Main St
Middletown, CT 06457-5050

Phone

(860) 346-0771

Fax

(860) 346-0772

NPI assigned

Apr 17, 2017

Last updated

Apr 17, 2017By 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

Ms. Shelly Lickwar, LCSW

Title

Clinical Director

Phone

(860) 346-0771

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1659805737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 S MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064575050",
            "telephone_number": "860-346-0771",
            "fax_number": "860-346-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 S MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064575050",
            "telephone_number": "860-346-0771",
            "fax_number": "860-346-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-17",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "LICKWAR",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "860-346-0771",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "3737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Chai, MD
• Joy E Chance
• Hana Chang, LCSW
• Johnny A. Chang, M.D.
• Change Inc
• Clara Fellows Chapman, PH.D.
• Sherie L Chapman, LCSW
• John Chardavoyne, MD
• Kristen Charpentier, MSW
• Chelsea Dicicco Counseling Services LLC

• Social Worker in Middletown, CT
• Providers in Middletown, CT by specialty
• Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; 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.