Healthcare Provider Details

I. General information

NPI: 1831110097
Provider Name (Legal Business Name): CHANGEPOINT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 SCHOOL ST SUITE 3
GLASTONBURY CT
06033-2241
US

IV. Provider business mailing address

18 SCHOOL ST SUITE 3
GLASTONBURY CT
06033-2241
US

V. Phone/Fax

Practice location:
  • Phone: 860-633-0703
  • Fax:
Mailing address:
  • Phone: 860-633-0703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number2429
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2429
License Number StateCT

VIII. Authorized Official

Name: DR. GEORGE GEYSEN
Title or Position: MANAGER AND MEMBER
Credential: PSY.D.
Phone: 860-633-0703