CHANGING LIVES ADULT & YOUTH SERVICES (NPI# 1609320340) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609320340 |
| Entity Type | Organization |
| Organization Name | CHANGING LIVES ADULT & YOUTH SERVICES |
| Practice Address |
9015 Woodyard Rd Ste 109 Clinton MD 20735-4226 |
| Practice Telephone | 2402442924 |
| Practice Fax Number | 2402445225 |
| Mailing Telephone | 2402442924 |
| Mailing Fax Number | 2402445225 |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2019-09-10 |
| Authorized Official Name | MR. SYDNEY BASKINS (CEO) |
| Authorized Official Telephone | 3015410963 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | 1771 | MD | Agencies |
| Y | 251S00000X | Community/Behavioral Health | 1771 | MD | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 1609320340 | 05 | |
| MD | 1902241250 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902241250 | Changing Lives Adult & Youth Services | Clinic/Center | 4810 Saint Barnabas Rd Ste 203, Temple Hills, MD 20748-4604 | 2013-04-30 |
| Street Address |
9015 WOODYARD RD STE 109 |
| City | CLINTON |
| State | MD |
| Zip Code | 20735-4226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780146217 | Yazmin Beeks | Social Worker | 9015 Woodyard Rd Ste 109, Clinton, MD 20735-4226 | 2019-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760940456 | Elise Olson | Occupational Therapist | 9135 Piscataway Rd, Suite 305, Clinton, MD 20735 | 2019-03-12 |
| 1437651742 | Total You Integrative Healthcare Inc | Clinic/Center | 9135 Piscataway Rd Ste 410, Clinton, MD 20735 | 2018-03-02 |
| 1386193233 | Benedicta C Osamor | Home Health Aide | 6808 Purple Lilac Ln, Clinton, MD 20735 | 2016-10-03 |
| 1669926309 | Frankline Ngozi Obi I | Home Health Aide | 8111 Highland Meadows Dr, Clinton, MD 20735 | 2016-08-11 |
| 1770952459 | Adventures One, Inc. | Clinic/Center | 7121 Old Alexandria Ferry Rd., Clinton, MD 20735 | 2015-09-23 |
| 1730574831 | Lindsey Degeorge | Emergency Medicine | 7503 Surratts Rd Dept Of, Clinton, MD 20735 | 2015-04-06 |
| 1316341860 | Margaret Laurence-whitlock | Speech-Language Pathologist | 5807 Terence Dr., Laurence Learning Center, Clinton, MD 20735 | 2014-10-13 |
| 1699103622 | Dcps | Social Worker | 5504 Trout Run Rd, Clinton, MD 20735 | 2013-10-30 |
| 1902232614 | Rafael Antonio Acosta | Dentist | 7905 Malcolm Rd Ste 300, Clinton, MD 20735 | 2013-09-25 |
| 1407135874 | Richelle Wilson Harvey | Occupational Therapist | 8202 Shackelford Way, Clinton, MD 20735 | 2011-08-16 |
| Find all providers in zip 20735 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356956528 | Anchor Wellness LLC | Community/Behavioral Health | 22 N High St, Clinton, CT 06413-1731 | 2020-09-14 |
| 1194349795 | Creative Sisters Counseling LLC | Community/Behavioral Health | 134 Fairmont St Ste C, Clinton, MS 39056-4739 | 2020-05-31 |
| 1114570173 | Strive Therapeutic Services Inc | Community/Behavioral Health | 1508 Neptune Dr, Clinton, OK 73601-9706 | 2019-07-18 |
| 1467987701 | One Hope, LLC | Community/Behavioral Health | 2 Dove Way Cir, Clinton, MS 39056-3589 | 2017-04-24 |
| 1043751548 | Wilma Gaines | Community/Behavioral Health | 7801 Royal Fern Ct, Clinton, MD 20735-2054 | 2017-03-16 |
| 1417409152 | Ursula Shaw | Community/Behavioral Health | 10105 Plank Rd. Ste A, Clinton, LA 70722 | 2016-10-28 |
| 1003365164 | Right Path House, LLC | Community/Behavioral Health | 23 Elmwood Way, Clinton, CT 06413-1508 | 2016-09-29 |
| 1912452095 | Restore Counseling and Consulting Services | Community/Behavioral Health | 610 E Leake St, Clinton, MS 39056-4321 | 2016-08-18 |
| 1245691187 | Frelix Consulting | Community/Behavioral Health | 207 Trailwood Dr, Clinton, MS 39056-5844 | 2016-03-18 |
| 1861880585 | Counseling & Assesment Clinic | Community/Behavioral Health | 1 Coolidge Pl Suit 712, Clinton, MA 01510 | 2015-01-05 |
| Find all providers in CLINTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.