Changing Perspectives Youth and Family Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C09396 Issued in NM

Legal business name

CHANGING PERSPECTIVES YOUTH AND FAMILY SERVICES, LLC

Practice address

4312 Carlisle Blvd NE
Albuquerque, NM 87107-4811

Phone

(505) 366-9106

NPI assigned

Apr 18, 2016

Last updated

Jul 11, 2016By 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

Mary Jo Picha, LCSWNPI 1083048037

Title

Psychotherapist/Social Worker

Phone

(505) 366-9106

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Mary Jo Picha, LCSW

  • Clinical Social Worker
  • Albuquerque, NM
  • NPI 1083048037
  NPD (past) Authorized official

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468195200000",
    "number": "1790139673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3524 RIO GRANDE BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871073038",
            "telephone_number": "505-366-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4312 CARLISLE BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074811",
            "telephone_number": "505-366-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING PERSPECTIVES YOUTH AND FAMILY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-18",
        "last_updated": "2016-07-11",
        "status": "A",
        "authorized_official_last_name": "PICHA",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST/SOCIAL WORKER",
        "authorized_official_telephone_number": "505-366-9106",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C09396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83230513",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05552893",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sangsoon Chang, D.O.M
• Sedjenane Chang
• Shu-Ching Catherine Chang, DMD
• Vivianne Michelle Chang, DO
• Changing Lives LLC
• Changing Seasons Therapy, LLC
• Changing Woman Initiative
• Grant Penn Chanin, CNP
• Julie Chanin
• Luxana Chanprakrit

• Clinical Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; 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.