MEDICARE: CONCEPTS FOR CHANGE

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	251S00000X	Community/Behavioral Health Agency	BH1690	AZ

General Provider Information

NPI Number	:	1427100643
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONCEPTS FOR CHANGE

Provider Business Mailing Address
First Line	:	5008 W GLENDALE AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85301-2751
Country	:	US
Telephone Number	:	623-930-9317
Fax Number	:	623-930-9521

Provider Business Practice Location Address
First Line	:	5008 W GLENDALE AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85301-2751
Country	:	US
Telephone Number	:	623-930-9317
Fax Number	:	623-930-9521

Authorized Official
Title or Position	:	EXECUTIVE CLINICAL DIRECTOR & CEO
Name	:	DR. LYNDA KAY HEMAN
Credential	:	PHD, MS, MPH, LISAC
Telephone Number	:	623-930-9317

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	09/06/2023

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Directions to “CONCEPTS FOR CHANGE ” Practice Location

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