CMS-1500 Box 24J / 33a • NPI
1639707839
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
103TC1900X (CMS 62)
Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Counseling
Box 32 Service Location & ZIP+4
5900 ROUTE US 60 W, SUITE A, ASHLAND, KY, 41102-9508
✓ 9-Digit EDI 837 ZIP+4 (41102-9508)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1639707839 (A CENTER FOR CHANGE) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1639707839 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | A CENTER FOR CHANGE |
| Plain-English Specialty | Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Counseling NUCC Code: 103TC1900X (Psychologist, Counseling) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 5900 ROUTE US 60 W, SUITE A, ASHLAND, KY, 41102-9508 |
| Practice Telephone / Fax | Tel: (606) 928-5116 |
| Administrative Mailing Address | PO BOX 5074, ASHLAND, KY, 41105-5074 |
| Enumeration & Last Sync | Enumerated: 2020-04-01 | CMS Record Updated: 2020-06-29 |
| Authorized Official | TONYA BOND JUDD (President) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (103TC1900X)
What Does Taxonomy Code 103TC1900X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103TC1900X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Counseling"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (A CENTER FOR CHANGE)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
103TC1900X — Psychologist, CounselingPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Counseling | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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