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CHANGE ACADEMY AT LAKE OF THE OZARKS
NPI 1326766304
Clinic/Center - Mental Health (Including Community Mental Health Center) in Rockville, MD

Active since August 16, 2022CLIA 21D2272239 · Waiver
1445 RESEARCH BLVD STE 100, ROCKVILLE, MD 20850(301) 985-2304 Get Directions Write a Review

NPPES record last updated: May 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 21, 2025, Jun 20, 2023, Apr 3, 2023 and 2 more (5 updates tracked since 2022).

About Change Academy At Lake Of The Ozarks NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHANGE ACADEMY AT LAKE OF THE OZARKS (NPI 1326766304) is a healthcare organization registered as a mental health (including community mental health center) in Rockville, Maryland and active in the NPI registry since August 2022. The organization holds a CLIA Waiver certificate valid through November 15, 2026 and lists Sharnell Spencer, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1326766304
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameCHANGE ACADEMY AT LAKE OF THE OZARKS
Location Address1445 RESEARCH BLVD STE 100Rockville, MD 20850-6130
Mailing Address5500 Ming Ave Ste 410Bakersfield, CA 93309-4631 · (661) 622-4132
Phone(301) 985-2304
Organization SubpartYesParent: Change Academy At Lake Of The Ozarks, Llc
Authorized OfficialSharnell SpencerCredentialing Manager · (661) 239-6923
Enumeration DateAugust 16, 2022
Last NPPES UpdateMay 21, 20255 updates tracked since enumeration
NPPES CertifiedMay 21, 2025
✔ NPI 1326766304 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
1445 RESEARCH BLVD STE 100, Rockville, MD 20850
Open in Google Maps ↗

Other Names 1

Other NameEmbark At Rockville

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D2272239

Change Academy At Lake Of The Ozarks- Embark At Ro · Rockville, MD
Active · expires Nov 15, 2026
CLIA Number21D2272239
Laboratory TypeMental Health
Certificate Effective DateNovember 16, 2024
Certificate Expiration DateNovember 15, 2026
Laboratory DirectorHarwant Gill
Laboratory Phone(571) 207-7454
Laboratory LocationChange Academy At Lake Of The Ozarks- Embark At Ro1445 Research Blvd Suite 100, Rockville, MD 20850
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEBORA SILVA SANTOS
Registered Nurse
1445 RESEARCH BLVD STE 100
ROCKVILLE, MD 20850
Montgomery County (301) 979-9405
ANOA HAWKINS
Counselor (Mental Health)
1445 RESEARCH BLVD STE 100
ROCKVILLE, MD 20850
Montgomery County (240) 552-5808
CARTER CAMPBELL TIPTON LMSW
Social Worker
1445 RESEARCH BLVD STE 100
ROCKVILLE, MD 20850
Montgomery County (240) 552-5808
ANDREA THEIS
Student in an Organized Health Care Education/Training Program
1445 RESEARCH BLVD STE 100
ROCKVILLE, MD 20850
Montgomery County (240) 552-5808
HALEY CRABB LCSW-C
Social Worker (Clinical)
1445 RESEARCH BLVD STE 100
ROCKVILLE, MD 20850
Montgomery County (240) 522-5808
LANDON WIGG LGPC
Counselor
1445 RESEARCH BLVD STE 100
ROCKVILLE, MD 20850
Montgomery County (301) 985-2304
ALYSSA DEGRACE LCPC
Counselor (Mental Health)
1445 RESEARCH BLVD STE 100
ROCKVILLE, MD 20850
Montgomery County (301) 407-2404
DIAMOND BENTON
Social Worker
1445 RESEARCH BLVD STE 100
ROCKVILLE, MD 20850
Montgomery County (240) 552-5808

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Change Academy At Lake Of The Ozarks's NPI number?

The NPI number for Change Academy At Lake Of The Ozarks is 1326766304. It was assigned to this organization in the NPPES registry on August 16, 2022. The provider is also known as Embark at Rockville.

Where is Change Academy At Lake Of The Ozarks located?

Change Academy At Lake Of The Ozarks is located at 1445 Research Blvd Ste 100, Rockville, MD 20850. The listed phone number is (301) 985-2304.

What is Change Academy At Lake Of The Ozarks's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Does Change Academy At Lake Of The Ozarks hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2272239) is associated with this NPI, valid through November 15, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Change Academy At Lake Of The Ozarks was last updated on May 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.