Organization Active NPI

New Changes LLC

Doing business as NEW Changes LLC Counseling

  • Professional Counselor
  • De Pere, WI
National Provider Identifier
1730928532
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
NEW CHANGES LLC
Doing business as
NEW Changes LLC Counseling
Practice address
3311 S Packerland Dr
Suite a #19
De Pere, WI 54115-9539
Phone
(920) 530-4433
Fax
(920) 688-4261
NPI assigned
May 21, 2024
Last updated
May 21, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
NEW CHANGES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Authorized official

Name
Bobbie Jo Lee Bleser, LPC, CSACNPI 1255640033
Title
Owner/Psychologist
Phone
(920) 530-4433

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

3311 S Packerland Dr
Suite a #19
De Pere, WI 54115-9539

Mailing address

3311 S Packerland Dr
Suite a #19
De Pere, WI 54115-9539
Phone (920) 530-4433

Other identifiers 1

IdentifierTypeStateIssuer
10021415MedicaidWI

Other names 1

  • NEW Changes LLC Counseling Doing business as

National Provider Directory

National Provider Directory
Tax ID family
New Changes LLC2 organizations share this tax ID, including this one
Part of
New Changes LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1730928532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 S PACKERLAND DR",
            "address_2": "SUITE A #19",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159539",
            "telephone_number": "920-530-4433",
            "fax_number": "920-688-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 S PACKERLAND DR",
            "address_2": "SUITE A #19",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159539",
            "telephone_number": "920-530-4433",
            "fax_number": "920-688-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW CHANGES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEW CHANGES LLC",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "BLESER",
        "authorized_official_first_name": "BOBBIE JO",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "920-530-4433",
        "authorized_official_credential": "LPC, CSAC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10021415",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEW Changes LLC Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in De Pere, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.