Provider Demographics
NPI:1831359603
Name:CHANGE HAPPENS, INC
Entity type:Organization
Organization Name:CHANGE HAPPENS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMONE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, LADC I, ICDP
Authorized Official - Phone:413-536-1918
Mailing Address - Street 1:71 MARY ST
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-1139
Mailing Address - Country:US
Mailing Address - Phone:413-536-1918
Mailing Address - Fax:
Practice Address - Street 1:71 MARY ST
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-1139
Practice Address - Country:US
Practice Address - Phone:413-536-1918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-14
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1181101YA0400X
MA117951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1036490OtherBEACON
MA1036490OtherFALLON
726247000OtherMAGELLAN
MA7282632OtherAETNA
MA1853171Medicaid
MAP08297OtherBLUE CROSS / BLUE SHILED
MA1853171Medicaid