Changing Lives Networks Inc

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

CHANGING LIVES NETWORKS INC

Practice address

1020 Brookstown Ave Ste 5&6
Winston Salem, NC 27101-2523

Phone

(336) 293-6535

NPI assigned

Dec 14, 2022

Organization subpart

No

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

Authorized official

Name

Jaquay Wade

Title

Director

Phone

(336) 516-6187

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Telina Faye Mathews, MA, LPC

  • Mental Health Counselor
  • Creedmoor, NC
  • NPI 1841473212
  NPD

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1720790447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 DAY AVE",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272172505",
            "telephone_number": "336-516-6187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 BROOKSTOWN AVE STE 5&6",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271012523",
            "telephone_number": "336-293-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING LIVES NETWORKS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-14",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "JAQUAY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-516-6187"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vidhya Chandramohan, M.D.
• Mahesh Anand Chandrasekhar, M.D.
• Ashley Lauren Chang
• Emily Chang
• Mark Jesse Chang, MD
• Jennifer Jenkins Chao, FNP-BC
• Simon Wen-Wei Chao, MD
• Ashley Snell Chaplin, M.D.
• Chapman & Owens DDS PLLC
• Christopher Ellis Chapman, FNP

• Mental Illness Community Based Residential Treatment Facility in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Mental Illness Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.