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CHANGE ACADEMY AT LAKE OF THE OZARKS
NPI 1962250415
Clinic/Center - Mental Health (Including Community Mental Health Center) in Bend, OR

Active since May 09, 2024
63140 DICKEY RD, BEND, OR 97701(480) 550-9281 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, Sep 11, 2024, May 9, 2024 (3 updates tracked since 2024).

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 1962250415) is a healthcare organization registered as a mental health (including community mental health center) in Bend, Oregon and active in the NPI registry since May 2024. The organization lists Sharnell Spencer, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1962250415
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameCHANGE ACADEMY AT LAKE OF THE OZARKS
Location Address63140 DICKEY RDBend, OR 97701-9742
Mailing Address5500 Ming Ave Ste 410Bakersfield, CA 93309-4631 · (661) 622-4132
Phone(480) 550-9281
Organization SubpartYes
Authorized OfficialSharnell SpencerCredentialing Manager · (661) 239-6923
Enumeration DateMay 9, 2024
Last NPPES UpdateMay 21, 20253 updates tracked since enumeration
NPPES CertifiedMay 21, 2025
✔ NPI 1962250415 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
63140 DICKEY RD, Bend, OR 97701
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Other Names 1

Other NameEmbark Virtual At Oregon

Other Providers at the Same Location NPPES 3

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

JACK C MCDOWELL RN
Registered Nurse
63140 DICKEY RD
BEND, OR 97701
Deschutes County (541) 668-7054
MOLLY MARTIN
Counselor (Mental Health)
63140 DICKEY RD
BEND, OR 97701
Deschutes County (320) 237-3070
MRS. BRITNIE HOOD LPN
Registered Nurse
63140 DICKEY RD
BEND, OR 97701
Deschutes County (541) 213-2773

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 1962250415. It was assigned to this organization in the NPPES registry on May 9, 2024. The provider is also known as Embark Virtual at Oregon.

Where is Change Academy At Lake Of The Ozarks located?

Change Academy At Lake Of The Ozarks is located at 63140 Dickey Rd, Bend, OR 97701. 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.

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.