NPIMap

Organization Active NPI

Life Changes, LLC

  • Mental Health Counselor
  • Middletown, CT
National Provider Identifier
1902107428
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
001763 Issued in CT
Legal business name
LIFE CHANGES, LLC
Practice address
193 Main St
Middletown, CT 06457-3423
Phone
(860) 944-1171
Fax
(860) 829-1550
NPI assigned
Nov 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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

Authorized official

Name
Mr. Andrew Brooks Degling, LPCNPI 1790010288
Title
Owner
Phone
(860) 944-1171

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 001763 CT Primary

Addresses

Primary practice location

193 Main St
Middletown, CT 06457-3423

Mailing address

147 Main St
East Berlin, CT 06023-1136
Phone (860) 944-1171

National Provider Directory

National Provider Directory

Locations

193 Main St
Middletown, CT 06457
Phone (860) 343-0321

Practitioners & affiliated clinicians

Practitioners 1

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": "1289779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289779200000",
    "number": "1902107428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 MAIN ST",
            "city": "EAST BERLIN",
            "state": "CT",
            "postal_code": "060231136",
            "telephone_number": "860-944-1171",
            "fax_number": "860-829-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573423",
            "telephone_number": "860-944-1171",
            "fax_number": "860-829-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHANGES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-15",
        "last_updated": "2010-11-15",
        "status": "A",
        "authorized_official_last_name": "DEGLING",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "BROOKS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-944-1171",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "001763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.