OrganizationActive
Change Inc
NPI 1316203706 · Case Management Agency · Middletown, CT
Provider details
- NPI number
- 1316203706
- Entity type
- Organization
- Primary specialty
- Case Management AgencyAgencies
- Organization subpart
- No
- Authorized official
- Derrick Gibbs, President / C.e.o.(860) 346-0771
Specialties & taxonomies
Agencies
- Preferred Provider Organization305R00000X
Managed Care Organizations
- Clinical Social Worker1041C0700X
Behavioral Health & Social Service Providers
- Professional Counselor101YP2500X
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1251 S Main St
Middletown, CT 06457-5050
Phone: (860) 346-0771
Fax: (860) 346-0772
Street-level locationGet directions
Mailing address
1251 S Main St
Middletown, CT 06457-5050
Registry dates
- Enumerated
- 2012-04-10
- Last updated
- 2015-05-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.