NPIMap

Organization Active NPI

Therapeutic Change PLLC

  • Marriage & Family Therapist
  • Vancouver, WA
National Provider Identifier
1821653239
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
THERAPEUTIC CHANGE PLLC
Practice address
1314 Kauffman Ave
Vancouver, WA 98660-2725
Phone
(360) 602-1477
Fax
(360) 334-5508
NPI assigned
May 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Authorized official

Name
Summer Lyn Brown, M.S.NPI 1235381930
Title
Owner/ Clinician
Phone
(360) 602-1477

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X Primary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

1314 Kauffman Ave
Vancouver, WA 98660-2725

Mailing address

1314 Kauffman Ave
Vancouver, WA 98660-2725
Phone (360) 602-1477

Other practice location 1

1314 Kauffman Ave
Vancouver, WA 98660-2725
Phone (360) 602-1477

Other names 1

  • Therapeutic Change PLLC Doing business as

National Provider Directory

National Provider Directory

Locations

1314 Kauffman Ave
Vancouver, WA 98660
Phone (360) 602-1477

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556668800000",
    "number": "1821653239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 KAUFFMAN AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602725",
            "telephone_number": "360-602-1477",
            "fax_number": "360-334-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 KAUFFMAN AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602725",
            "telephone_number": "360-602-1477",
            "fax_number": "360-334-5508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1314 Kauffman Ave",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986602725",
            "country_code": "US",
            "telephone_number": "360-602-1477",
            "fax_number": "360-334-5508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THERAPEUTIC CHANGE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-01",
        "last_updated": "2019-05-01",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "SUMMER",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "OWNER/ CLINICIAN",
        "authorized_official_telephone_number": "360-602-1477",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Therapeutic Change PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; 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.