Organization
CHANGE HAPPENS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RENEE SIMONE LICSW, LADC I, ICDP (PRESIDENT)
(413) 536-1918
Entity
Organization
Contact information
Practice address
71 MARY ST, CHICOPEE, MA 01020-1139
(413) 536-1918
Mailing address
71 MARY ST, CHICOPEE, MA 01020-1139
(413) 536-1918
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1181
MA
1041C0700X
Clinical Social Worker
Primary
11795
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1036490
BEACON
MA
05
—
1853171
—
MA
01
—
726247000
MAGELLAN
—
01
—
7282632
AETNA
MA
01
—
P08297
BLUE CROSS / BLUE SHILED
MA
Enumeration date
06/14/2008
Last updated
03/05/2013
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