Provider Demographics
NPI:1427100643
Name:CONCEPTS FOR CHANGE
Entity type:Organization
Organization Name:CONCEPTS FOR CHANGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE CLINICAL DIRECTOR & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:HEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MS, MPH, LISAC
Authorized Official - Phone:623-930-9317
Mailing Address - Street 1:5008 W GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-2751
Mailing Address - Country:US
Mailing Address - Phone:623-930-9317
Mailing Address - Fax:623-930-9521
Practice Address - Street 1:5008 W GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-2751
Practice Address - Country:US
Practice Address - Phone:623-930-9317
Practice Address - Fax:623-930-9521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH1690251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health