| Change Happens, Inc | |
|
71 Mary St Chicopee MA 01020-1139 | |
| (413) 536-1918 | |
| Not Available |
| Full Name | Change Happens, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 71 Mary St, Chicopee, Massachusetts |
| Authorized Official Name and Position | Renee Simone (PRESIDENT) |
| Authorized Official Contact | 4135361918 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Change Happens, Inc 71 Mary St Chicopee MA 01020-1139 Ph: (413) 536-1918 | Change Happens, Inc 71 Mary St Chicopee MA 01020-1139 Ph: (413) 536-1918 |
| NPI Number | 1831359603 |
|---|---|
| Provider Enumeration Date | 06/14/2008 |
| Last Update Date | 03/05/2013 |
| Medicare PECOS PAC ID | 4183783384 |
|---|---|
| Medicare Enrollment ID | O20081103000410 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831359603 | NPI | - | NPPES |
| 1036490 | Other | MA | BEACON |
| 1036490 | Other | MA | FALLON |
| 726247000 | Other | MAGELLAN | |
| 7282632 | Other | MA | AETNA |
| 1853171 | Medicaid | MA | |
| P08297 | Other | MA | BLUE CROSS / BLUE SHILED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1181 (Massachusetts) | Secondary |
| 1041C0700X | Social Worker - Clinical | 11795 (Massachusetts) | Primary |
| Provider Name | Renee Simone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053497206 PECOS PAC ID: 4385638212 Enrollment ID: I20200511001471 |
| Provider Name | Courtney Marie Bordo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770338154 PECOS PAC ID: 2860924248 Enrollment ID: I20241010003097 |
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