CHANGE ACADEMY AT LAKE OF THE OZARKS
NPI 1962250415
Clinic/Center - Mental Health (Including Community Mental Health Center) in Bend, OR

NPI Status: Active since May 09, 2024

Contact Information

63140 DICKEY RD
BEND, OR
ZIP 97701
Phone: (480) 550-9281

Get Directions Reviews

  • Organization
  • Clinic/Center
  • Mental Health (Including Community Menta...

About CHANGE ACADEMY AT LAKE OF THE OZARKS

This page provides the complete NPI Profile along with additional information for Change Academy At Lake Of The Ozarks, a provider established in Bend, Oregon operating as a Clinic/center, focusing in mental health (including community mental health center) . The healthcare provider is registered in the NPI registry with number 1962250415 assigned on May 2024. The practitioner's primary taxonomy code is 261QM0801X. The provider is registered as an organization and their NPI record was last updated May 2025. The provider's . The authorized official of this NPI record is Sharnell Spencer (Credentialing Manager)

NPI
1962250415
Provider Legal Name
CHANGE ACADEMY AT LAKE OF THE OZARKS
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
63140 DICKEY RD BEND, OR 97701
Location Phone
(480) 550-9281
Mailing Address
5500 MING AVE STE 410 BAKERSFIELD, CA 93309
Mailing Phone
(661) 622-4132
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
05-09-2024
Last Update Date
05-21-2025
Code Navigator

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Mental Health (Including Community Mental Health Center)

Taxonomy Code
261QM0801X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

SHARNELL SPENCER

Authorized Official Title
CREDENTIALING MANAGER
Authorized Official Phone
(661) 239-6923

Reviews for CHANGE ACADEMY AT LAKE OF THE OZARKS

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1962250415
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2912245042
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 1 + 2 + 2 + 4 + 5 + 0 + 4 + 2 + 24 = 55
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 55 = 55

The NPI number 1962250415 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 6 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1780357863 BREANA JUDITH STANFORD
Individual
Counselor63140 DICKEY RD
BEND, OR 97701
(877) 820-5050
1518731686MRS. CAROLINE QUINN WOLF
Individual
Counselor (Professional)63140 DICKEY RD
BEND, OR 97701
(541) 318-1676
1083473441 JACK C MCDOWELL RN
Individual
Registered Nurse63140 DICKEY RD
BEND, OR 97701
(541) 668-7054
1659176030 MOLLY MARTIN
Individual
Counselor (Mental Health)63140 DICKEY RD
BEND, OR 97701
(320) 237-3070
1740081074MRS. BRITNIE HOOD LPN
Individual
Registered Nurse63140 DICKEY RD
BEND, OR 97701
(541) 213-2773
1194437004CHANGE ACADEMY AT LAKE OF THE OZARKS
Organization
Residential Treatment Facility, Emotionally Disturbed Children63140 DICKEY RD
BEND, OR 97701
(541) 318-1676

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1962250415, enumerated in the NPI registry as an "organization" on May 09, 2024

The provider is located at 63140 Dickey Rd Bend, Or 97701 and the phone number is (480) 550-9281

This medical organization specializes in Clinic/Center with taxonomy code 261QM0801X with a focus in Mental Health (Including Community Mental Health Center)

This NPI record was last updated on May 09, 2024. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.