NPIMap

Organization Active NPI

Changing Behavior Services, LLC

  • Community/Behavioral Health Agency
  • Shreveport, LA
National Provider Identifier
1902103617
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
10111532#MVA42 Issued in LA
Legal business name
CHANGING BEHAVIOR SERVICES, LLC
Practice address
1434 Hawn Ave
Ste. 12
Shreveport, LA 71107-6508
Phone
(318) 675-0224
Fax
(318) 675-0226
NPI assigned
Feb 15, 2011
Last updated
Jun 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Authorized official

Name
Ms. Pamela Michelle Phillips, MBA
Title
Owner
Phone
(318) 617-5869

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 10111532#MVA42 LA Primary
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

1434 Hawn Ave
Ste. 12
Shreveport, LA 71107-6508

Mailing address

PO Box 7875
Shreveport, LA 71137-7875
Phone (318) 675-0224

Other practice location 1

1434 Hawn Ave
Ste. 12
Shreveport, LA 71107-6508
Phone (318) 675-0224

National Provider Directory

National Provider Directory

Locations

1434 Hawn Ave
Ste 12
Shreveport, LA 71107
Phone (318) 675-0224

Practitioners & affiliated clinicians

Practitioners 41

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.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1902103617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7875",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711377875",
            "telephone_number": "318-675-0224",
            "fax_number": "318-675-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1434 HAWN AVE",
            "address_2": "STE. 12",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711076508",
            "telephone_number": "318-675-0224",
            "fax_number": "318-675-0226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1434 Hawn Ave",
            "address_2": "Ste. 12",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711076508",
            "country_code": "US",
            "telephone_number": "318-675-0224",
            "fax_number": "318-675-0226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHANGING BEHAVIOR SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-15",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-617-5869",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": "10111532#MVA42",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; 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.