CHANGING PHASES BEHAVIORAL SUPPORT, INC
NPI 1497094205
Community/Behavioral Health in Marietta, GA

Q: What is Changing Phases Behavioral Support, Inc's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Active since February 14, 2013CLIA 11D2100302 · Waiver

3655 CANTON RD STE 201, MARIETTA, GA 30066(707) 261-1627(707) 702-5966 Get Directions Write a Review

NPPES record last updated: August 17, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 17, 2018, Jun 20, 2018 (2 updates tracked since 2018).

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About Changing Phases Behavioral Support, Inc NPPES

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

CHANGING PHASES BEHAVIORAL SUPPORT, INC (NPI 1497094205) is a healthcare organization registered as a community/behavioral health in Marietta, Georgia and active in the NPI registry since February 2013. The organization holds a CLIA Waiver certificate valid through August 11, 2027 and lists Mya S Cullins, Vice President, as its authorized official.

NPPES Registry Identity

NPI1497094205

Entity TypeOrganization

Primary Taxonomy251S00000X

Legal Business NameCHANGING PHASES BEHAVIORAL SUPPORT, INC

Location Address3655 CANTON RD STE 201Marietta, GA 30066

Mailing Address3655 Canton RdMarietta, GA 30066-2690 · (770) 726-1162 · Fax (770) 702-5966

Phone(707) 261-1627

Fax(707) 702-5966

Organization SubpartNo

Authorized OfficialMya S CullinsVice President · (336) 268-6469

Enumeration DateFebruary 14, 2013

Last NPPES UpdateAugust 17, 20182 updates tracked since enumeration

✔ NPI 1497094205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCommunity/Behavioral HealthAgencies

Taxonomy Code251S00000X

Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Also ListedInternal MedicineTaxonomy 207R00000X · License 25937 (GA)

3655 CANTON RD STE 201, Marietta, GA 30066

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Changing Phases Behavioral Support, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Changing Phases Behavioral Support, Inc, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Michael Austin, M.D.

Internal Medicine

NPI 1134155153

3020 HIGHWAY 124
Snellville, GA 30039

(770) 476-3636

✔ PECOS✔ Accepts Medicare32 mi

Miles Johnson, M.D.

Family Practice

NPI 1568419844

150 FIDDLERS RDG
Fayetteville, GA 30214

(404) 664-4578

✔ PECOS36 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 11D2100302

Changing Phases · Marietta, GA

Active · expires Aug 11, 2027

CLIA Number11D2100302

Laboratory TypeBh Agency

Certificate Effective DateAugust 12, 2025

Certificate Expiration DateAugust 11, 2027

Laboratory DirectorMya S. Cullins

Laboratory Phone(678) 903-5197

Laboratory LocationChanging Phases3655 Canton Road, Suite 201, Marietta, GA 30066

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

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 Changing Phases Behavioral Support, Inc's NPI number?

The NPI number for Changing Phases Behavioral Support, Inc is 1497094205. It was assigned to this organization in the NPPES registry on February 14, 2013.

Where is Changing Phases Behavioral Support, Inc located?

Changing Phases Behavioral Support, Inc is located at 3655 Canton Rd Ste 201, Marietta, GA 30066. The listed phone number is (707) 261-1627.

What is Changing Phases Behavioral Support, Inc's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Is Changing Phases Behavioral Support, Inc enrolled in Medicare?

Yes. Changing Phases Behavioral Support, Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Changing Phases Behavioral Support, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Changing Phases Behavioral Support, Inc, in Family Practice and Internal Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Changing Phases Behavioral Support, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2100302) is associated with this NPI, valid through August 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Changing Phases Behavioral Support, Inc accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Changing Phases Behavioral Support, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Changing Phases Behavioral Support, Inc was last updated on August 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.