Provider Demographics
NPI:1831110097
Name:CHANGEPOINT, LLC
Entity type:Organization
Organization Name:CHANGEPOINT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER AND MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:GEYSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:860-633-0703
Mailing Address - Street 1:18 SCHOOL ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2241
Mailing Address - Country:US
Mailing Address - Phone:860-633-0703
Mailing Address - Fax:
Practice Address - Street 1:18 SCHOOL ST
Practice Address - Street 2:SUITE 3
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2241
Practice Address - Country:US
Practice Address - Phone:860-633-0703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2429103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Multi-Specialty