NPIMap

Organization Active NPI

Winds of Change Psychological Services of Mobile

  • Clinical Psychologist
  • Mobile, AL
National Provider Identifier
1912236779
Registry record updated Jan 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
961 Issued in HI
Legal business name
WINDS OF CHANGE PSYCHOLOGICAL SERVICES OF MOBILE
Practice address
6341 Piccadilly Square Dr
Mobile, AL 36609-5103
Phone
(251) 343-5300
Fax
(251) 343-6613
NPI assigned
Dec 8, 2009
Last updated
Jan 5, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
WINDS OF CHANGE PSYCHOLOGICAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 5, 2010

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

Authorized official

Name
Jennifer Lynn Adams, PH.D.NPI 1225171671
Title
Ceo, President
Phone
(251) 824-8602

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
Clinical Psychologist 103TC0700X 961 HI Primary

Addresses

Primary practice location

6341 Piccadilly Square Dr
Mobile, AL 36609-5103

Mailing address

15360 Clark Rd
Coden, AL 36523-3206
Phone (251) 824-8602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101012000805 AL Part B Supplier - Clinic/Group Practice 6608068481 Receives reassigned benefits from 1 practitioner
Practice locations: Bayou la Batre, AL; Mobile, AL

National Provider Directory

National Provider Directory
Part of
Winds of CHG Osy SVCS

Locations

13465 N Wintzell Ave
Bayou La Batre, AL 36509
Phone (251) 343-5300

6341 Piccadilly Square Dr
Mobile, AL 36609
Phone (251) 343-5300

6341 Piccadilly Square Dr
#A
Mobile, AL 36609
Phone (251) 343-5300

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262649600000",
    "number": "1912236779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15360 CLARK RD",
            "city": "CODEN",
            "state": "AL",
            "postal_code": "365233206",
            "telephone_number": "251-824-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6341 PICCADILLY SQUARE DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366095103",
            "telephone_number": "251-343-5300",
            "fax_number": "251-343-6613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDS OF CHANGE PSYCHOLOGICAL SERVICES OF MOBILE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WINDS OF CHANGE PSYCHOLOGICAL SERVICES",
        "enumeration_date": "2009-12-08",
        "last_updated": "2010-01-05",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CEO, PRESIDENT",
        "authorized_official_telephone_number": "251-824-8602",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; 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.