CHANGE ACADEMY AT LAKE OF THE OZARKS
NPI 1568188340
Clinic/Center - Mental Health (Including Community Mental Health Center) in Ashburn, VA
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 1568188340) is a healthcare organization registered as a mental health (including community mental health center) in Ashburn, Virginia and active in the NPI registry since October 2022. The organization holds a CLIA Waiver certificate valid through February 14, 2027 and lists Sharnell Spencer, Credentialing Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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 49D2276785
Change Academy At Lake Of The Ozarks LLC Embark At Ashburn · Ashburn, VAOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ASHBURN, VA 20147
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 1568188340. It was assigned to this organization in the NPPES registry on October 13, 2022. The provider is also known as Embark Virtual at Virginia.
Where is Change Academy At Lake Of The Ozarks located?
Change Academy At Lake Of The Ozarks is located at 20116 Ashbrook Pl Ste 110, Ashburn, VA 20147. The listed phone number is (480) 550-9281.
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 49D2276785) is associated with this NPI, valid through February 14, 2027. 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 15 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.
# Change Academy At Lake Of The Ozarks · NPI 1568188340
Mental Health (Including Community Mental Health Center) organization in Ashburn, Virginia. Organization record, active in the CMS NPPES registry since October 13, 2022.
## Identity
- **NPI:** 1568188340 (Entity type: Organization)
- **Enumerated:** October 13, 2022
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Also known as:** Embark Virtual at Virginia (Other Name)
- **Organization subpart:** Yes (part of Change Academy At Lake Of The Ozarks)
- **Authorized official:** Sharnell Spencer, CREDENTIALING MANAGER
## Practice location
- **Address:** 20116 ASHBROOK PL STE 110, Ashburn, VA 20147-5086
- **Phone:** (480) 550-9281
## Record status
- **NPPES last updated:** May 21, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1568188340) · Data from the CMS NPPES public registry.