Change & Growth Therapy Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW12223 Issued in FL

Legal business name

CHANGE & GROWTH THERAPY CENTER

Practice address

8401 Lake Worth Rd
Ste. 202
Lake Worth, FL 33467-2400

Phone

(561) 635-2431

NPI assigned

Mar 28, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Mayra Bagnoli

Title

Owner

Phone

(561) 635-2341

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490659200000",
    "number": "1760914931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 LAKE WORTH RD",
            "address_2": "STE. 202",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 LAKE WORTH RD",
            "address_2": "STE. 202",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672400",
            "telephone_number": "561-635-2431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE & GROWTH THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-28",
        "last_updated": "2017-03-28",
        "status": "A",
        "authorized_official_last_name": "BAGNOLI",
        "authorized_official_first_name": "MAYRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-635-2341",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cfsatc Inc
• Donald Chamberlin, LMHC
• Janhoi T Chambers, CSFA
• Jeremy Dalisay Chan
• Chandler Health Systems LLC
• Carmen Yaneth Chantre
• Laura Chapman, CRS,CDDC,CACII,CNDAI
• Jacqueline Charbonneau
• Charles W. Schmidt DDS, PA
• Raoul Charles, TT

• Clinical Social Worker in Lake Worth, FL
• Providers in Lake Worth, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.