Frontiers in Change LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FRONTIERS IN CHANGE LLC

Practice address

1719 Grandin Rd SW
Roanoke, VA 24015-2815

Phone

(115) 408-1956

NPI assigned

Jun 22, 2022

Last updated

Jun 22, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Benjamin Owen, MSSW, LCSWNPI 1558380261

Title

Owner

Phone

(540) 632-1434

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Benjamin David Owen, LCSW

  • Clinical Social Worker
  • Roanoke, VA
  • NPI 1558380261
  NPD Authorized official

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1932830783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5052 PLEASANT HILL DR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183456",
            "telephone_number": "540-632-1434",
            "fax_number": "707-679-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 GRANDIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240152815",
            "telephone_number": "115-408-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONTIERS IN CHANGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-632-1434",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.