Provider Demographics
NPI:1447594312
Name:CHANGES COUNSELING LLC
Entity Type:Organization
Organization Name:CHANGES COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP, LADC
Authorized Official - Phone:402-669-6204
Mailing Address - Street 1:9374 N ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-2307
Mailing Address - Country:US
Mailing Address - Phone:402-669-6204
Mailing Address - Fax:
Practice Address - Street 1:9374 N ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-2307
Practice Address - Country:US
Practice Address - Phone:402-669-6204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE992101YA0400X
NE871251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026192600OtherNPI