Change Formation LLC
NPI 1255989109ActiveOrganization· Social Worker, Clinical· Oak Park, IL
Social Worker, Clinical in Oak Park, Illinois, registered in NPPES in September 2019. The authorized official on file is Carol Morken, LCSW, Psychotherapist/Practice Owner.
Overview
| NPI | 1255989109 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 3, 2019 |
| Last updated in NPPES | Sep 3, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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