Organization
CENTER OF CHANGE
Active
Organization
CENTER OF CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE MCKENNA PHD (CO-OWNER)
(417) 888-0886
Entity
Organization
Contact information
Practice address
1615A S INGRAM MILL RD, SPRINGFIELD, MO 65804-2261
(417) 888-0886
(417) 888-0846
Mailing address
1615A S INGRAM MILL RD, SPRINGFIELD, MO 65804-2261
(417) 888-0886
(417) 888-0846
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY01825
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
508440609
—
MO
Enumeration date
02/18/2008
Last updated
05/01/2008
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