Organization
CHANGE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DERRICK CHRISTOPHER GIBBS JR. (PRESIDENT / C.E.O.)
(860) 346-0771
Entity
Organization
Contact information
Practice address
1251 S MAIN ST, MIDDLETOWN, CT 06457-5050
(860) 346-0771
(860) 346-0772
Mailing address
1251 S MAIN ST, MIDDLETOWN, CT 06457-5050
(860) 346-0771
(860) 346-0772
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
CT
1041C0700X
Clinical Social Worker
—
CT
251B00000X
Case Management Agency
Primary
—
CT
305R00000X
Preferred Provider Organization
—
—
Other
Enumeration date
04/10/2012
Last updated
05/13/2015
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up