NPIMap

Organization Active NPI

Change Counseling, LLC

  • Clinical Social Worker
  • Willimantic, CT
National Provider Identifier
1780141465
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CHANGE COUNSELING, LLC
Practice address
750R Main St
Willimantic, CT 06226-2504
Phone
(860) 833-2657
NPI assigned
Feb 28, 2019
Last updated
Feb 28, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Authorized official

Name
Madelyn Briggs
Title
Owner
Phone
(860) 833-2657

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

750R Main St
Willimantic, CT 06226-2504

Mailing address

261 Church St
Willimantic, CT 06226-2625
Phone (860) 833-2657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200127000687 CT Part B Supplier - Clinic/Group Practice 9234564956 Receives reassigned benefits from 10 practitioners
Practice locations: Mansfield Center, CT; Niantic, CT; Putnam, CT; Woodstock Valley, CT

National Provider Directory

National Provider Directory

Locations

6 Ledgebrook Dr
Ste C
Mansfield Center, CT 06250
Phone (860) 833-2657

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551312000000",
    "number": "1780141465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 CHURCH ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262625",
            "telephone_number": "860-833-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750R MAIN ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262504",
            "telephone_number": "860-833-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-28",
        "last_updated": "2019-02-28",
        "status": "A",
        "authorized_official_last_name": "BRIGGS",
        "authorized_official_first_name": "MADELYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-833-2657"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.