Therapy for Change PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301015616 Issued in MI

Legal business name

THERAPY FOR CHANGE PLLC

Practice address

120 E Liberty St
Ste 300
Ann Arbor, MI 48104-2156

Phone

(734) 730-5534

NPI assigned

Jul 5, 2016

Organization subpart

No

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

Authorized official

Name

Lisa Wolf, PSYDNPI 1740514777

Title

Owner/Authorized Official

Phone

(734) 730-5534

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

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

• Lisa Claire Wolf, PSYD

  • Clinical Psychologist
  • Ann Arbor, MI
  • NPI 1740514777
  Medicare reassignment Authorized official
• George Joseph Didier, PSYD

  • Clinical Psychologist
  • Rockford, IL
  • NPI 1164597365
  NPD (past)

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467676800000",
    "number": "1871945683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E LIBERTY ST",
            "address_2": "STE 300",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042156",
            "telephone_number": "734-730-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E LIBERTY ST",
            "address_2": "STE 300",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042156",
            "telephone_number": "734-730-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPY FOR CHANGE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-05",
        "last_updated": "2016-07-05",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "734-730-5534",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301015616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eby Ison Thekkedath, DO
• Lena Theodorou-Ehrlich, PSY.D.
• Thera Support
• Therabee
• Therapeutic Pharmacy Partners LLC
• Therasupport, LLC
• Theresa Gattari MD, PLLC
• Jane Theriault, RN
• Megan Megan Theuerkauf, DPT
• Amanda Theuerkorn

• Clinical Psychologist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; 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.