Cluster of Life Changes LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CLUSTER OF LIFE CHANGES LLC

Practice address

300 N Rufe Snow Dr
Keller, TX 76248-4235

Phone

(254) 289-2285

Fax

(682) 593-3936

NPI assigned

Oct 26, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Carnesha L Collins, LCSWNPI 1306405592

Title

Ceo

Phone

(254) 289-2285

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cluster of Life Changes Doing business as

Locations

Practitioners 1

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

• Carnesha L Collins, LCSW

  • Clinical Social Worker
  • Keller, TX
  • NPI 1306405592
  NPD Authorized official

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1821752833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 STERLING TRACE DR",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762489740",
            "telephone_number": "254-289-2285",
            "fax_number": "682-593-3936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N RUFE SNOW DR",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762484235",
            "telephone_number": "254-289-2285",
            "fax_number": "682-593-3936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5424 Rufe Snow Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "North Richland Hills",
            "state": "TX",
            "postal_code": "761806684",
            "country_code": "US",
            "telephone_number": "254-289-2285",
            "fax_number": "682-593-3936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CLUSTER OF LIFE CHANGES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "CARNESHA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "254-289-2285",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL TYPE I NPI",
            "identifier": "1306405592",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cluster of Life Changes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Berkeley Eden Church, LPC
• City of Keller
• Jordan Claunch
• Shakeita Clayton
• Erin Clifton, PT
• Dawn Colette Coffelt, MS PT
• Michael Colangelo, DDS
• Paris Cole
• Rosalina Cole
• Carol Lynn Coleman, LMFT

• Clinical Social Worker in Keller, TX
• Providers in Keller, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.