Provider Demographics
NPI:1508668906
Name:CHANGE THERAPY SERVICES, LLC
Entity type:Organization
Organization Name:CHANGE THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEILKE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:720-259-9947
Mailing Address - Street 1:1601 29TH ST. SUITE 1292
Mailing Address - Street 2:#1252
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301
Mailing Address - Country:US
Mailing Address - Phone:720-259-9947
Mailing Address - Fax:
Practice Address - Street 1:740 S PIERCE AVE #5
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027
Practice Address - Country:US
Practice Address - Phone:720-259-9947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty