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CHANGE WITHIN REACH LICENSED CLINICAL SOCIAL WORKER CORPORATION NPI 1003207002

NPI Profile

NPI: 1003207002
Provider Name: CHANGE WITHIN REACH, LICENSED CLINICAL SOCIAL WORKER CORPORATION
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
17777 VENTURA BLVD STE 105
ENCINO, CA
ZIP 91316
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Phone: (213) 445-2266

CHANGE WITHIN REACH, LICENSED CLINICAL SOCIAL WORKER CORPORATION is an adult mental health cliniccenter in Encino, CA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. CHANGE WITHIN REACH, LICENSED CLINICAL SOCIAL WORKER CORPORATION NPI is 1003207002. The provider is registered as an organization entity type.

The provider's business location address is:

17777 VENTURA BLVD STE 105
ENCINO, CA
ZIP 91316
Phone: (213) 445-2266
Fax: (213) 908-1233

The provider's authorized official is Anna Gershelis .
The authorized official title is President and has the following contact phone number (213) 445-2266.

The enumeration date for this NPI number is 2/11/2015 and was last updated on 5/23/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0850XClinic/CenterAdult Mental HealthLCSW28777CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11285901942MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/27/2020

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