Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Active Change Center, LLC

Organization Mental Health Counselor · NPI 1497028161

Active Change Center, LLC provides Mental Health Counselor services in Meridian, Idaho. Licensed in Idaho. Registered with an NPI since 2012.

Licensed in
ID
In the registry since
2012
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2498 N Stokesberry Pl Ste 180
Meridian, ID 83646
Phone: (208) 403-7488
Fax: (208) 529-1960
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X
Mental Health Counselor Taxonomy 101YM0800X
Professional Counselor Taxonomy 101YP2500X · Licence LCPC206 (ID)

Record details

NPI number1497028161
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Danny Rasco — Billing Agent · (208) 201-9513
Other names Active Change Center; Active Change Center
NPI enumeratedFebruary 10, 2012
Last updated in NPPESJuly 12, 2022
Certification dateJuly 12, 2022
Mailing addressP.O. Box 409, Meridian, ID 83680-0409

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