Organization · Type 2 NPI

Change Academy at Lake of the Ozarks

Mental Health Clinic/Center (Including Community Mental Health Center) · Stafford, TX

NPI number 1013635085 Active

Practice location

4800 Sugar Grove Blvd Ste 275
Stafford, TX 77477-2150

Call (888) 491-4177 Map

Mailing address

5500 Ming Ave Ste 410
Bakersfield, CA 93309-4631

Specialties and licenses

Taxonomy	Code	License
Mental Health Clinic/Center (Including Community Mental Health Center) Primary	261QM0801X	None listed

Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...

3 other providers at this address

Solacium Fulshear, LLCMental Health Clinic/Center (Including Community Mental Health Center) Stafford, TX NPI 1558148874
Injila ImamMental Health Counselor Stafford, TX NPI 1760100994
Ty Patterson, LPC-ASSOCIATEMental Health Counselor Stafford, TX NPI 1104788769

Other mental health clinic/center (including community mental health center) providers in Stafford

See all in Stafford →

NPI record

NPI: 1013635085
Entity type: Organization (Type 2)
Issued: Aug 16, 2022
Last updated: May 14, 2025
Status: Active
Subpart: Yes of Change Academy at Lake of the Ozarks

Other names

<unavail>
Embark Virtual at Texas · other name
Embark Virtual at Texas · other name

Authorized official

Sharnell Spencer
Credentialing Manager
(661) 239-6923

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1013635085

Change Academy at Lake of the Ozarks's National Provider Identifier is 1013635085, issued on Aug 16, 2022. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Stafford, TX. The record was last updated on May 14, 2025.