Effective Change LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

W4094131601 Issued in HI

Legal business name

EFFECTIVE CHANGE LLC

Practice address

56 Waianuenue Ave
Hilo, HI 96720-2474

Phone

(808) 934-7566

Fax

(808) 934-9442

NPI assigned

Nov 8, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Matthew Douglas Brittain, LCSW

Title

Owner

Phone

(808) 934-7566

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Mark Silvio Pedri, D.O. M.P.H.

  • General Practice Physician
  • Kaunakakai, HI
  • NPI 1417203126
  NPD (past)
• Linda Jan Boothe, LCSW

  • Clinical Social Worker
  • Bayboro, NC
  • NPI 1912931502
  NPD (past)

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289174400000",
    "number": "1831490887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1038",
            "city": "KURTISTOWN",
            "state": "HI",
            "postal_code": "967601038",
            "telephone_number": "808-934-7566",
            "fax_number": "808-934-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 WAIANUENUE AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202474",
            "telephone_number": "808-934-7566",
            "fax_number": "808-934-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EFFECTIVE CHANGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-08",
        "last_updated": "2010-11-08",
        "status": "A",
        "authorized_official_last_name": "BRITTAIN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-934-7566",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "HI",
            "license": "W4094131601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24819201",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Ebesugawa
• Jennie Ebesuno
• Jameylee Brandylynn Eblacas
• Ecare Hawaii LLC
• Jacqueline Economy
• Violet Egeler
• Isabel Eggers-Ehlert
• Elemental Guidance LLC
• Michael Jordan Elimon
• Meili Ellis-Tingle

• Community/Behavioral Health Agency in Hilo, HI
• Providers in Hilo, HI by specialty
• Community/Behavioral Health Agency in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; 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.