Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Active Change Center, LLC

Organization Mental Health Counselor · NPI 1497028161

Active Change Center, LLC is a Mental Health Counselor 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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