MEDICARE: POSITIVE CHANGES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C004204	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	556410	OTHER	NC	SUSANS VALUEOPTIONS NUMBE
2	7104624	OTHER	NC	AETNA PIN NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	138YJ	OTHER	NC	BCBSNC SUSAN
5	D9225	OTHER	NC	SUSANS MEDCOST
6	7162632	OTHER	NC	AETNA POSITIVE CHANGES
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	D9225	OTHER	NC	SUSANS MEDCOST PROVIDER

General Provider Information

NPI Number	:	1598760316
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POSITIVE CHANGES, INC

Provider Business Mailing Address
First Line	:	3200 BEECHLEAF CT
Second Line	:	SUITE 100
City	:	RALEIGH
State	:	NC
Zip	:	27604-1085
Country	:	US
Telephone Number	:	919-788-7878
Fax Number	:	919-424-8320

Provider Business Practice Location Address
First Line	:	3200 BEECHLEAF CT
Second Line	:	SUITE 100
City	:	RALEIGH
State	:	NC
Zip	:	27604-1085
Country	:	US
Telephone Number	:	919-788-7878
Fax Number	:	919-424-8320

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MR. ALLEN M WEST
Credential	:
Telephone Number	:	919-788-7878

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	08/22/2020

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Directions to “POSITIVE CHANGES, INC ” Practice Location

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