Organization Active NPI

Center for Personal Growth & Change

  • Mental Health Counselor
  • Norfolk, VA
National Provider Identifier
1053450817
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CENTER FOR PERSONAL GROWTH & CHANGE
Practice address
6350 Center Dr
Suite 110
Norfolk, VA 23502-4107
Phone
(757) 227-3072
Fax
(757) 227-3212
NPI assigned
Feb 6, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kim Sloan
Title
Office Manager
Phone
(757) 227-3072

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X VA Primary

Addresses

Primary practice location

6350 Center Dr
Suite 110
Norfolk, VA 23502-4107

Mailing address

6350 Center Dr
Suite 110
Norfolk, VA 23502-4107
Phone (757) 227-3072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070727000402 VA Part B Supplier - Clinic/Group Practice 4082715552 Receives reassigned benefits from 5 practitioners
Practice locations: Chesapeake, VA

National Provider Directory

National Provider Directory

Locations

3105 American Legion Rd
Ste F
Chesapeake, VA 23321
Phone (757) 227-3072

400 N Center Dr
Ste 124
Norfolk, VA 23502
Phone (757) 227-3072

6350 Center Dr
Ste 106
Norfolk, VA 23502
Phone (757) 227-3072

6350 Center Dr
Ste 110
Norfolk, VA 23502
Phone (757) 227-3072

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053450817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6350 CENTER DR",
            "address_2": "SUITE 110",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024107",
            "telephone_number": "757-227-3072",
            "fax_number": "757-227-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6350 CENTER DR",
            "address_2": "SUITE 110",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024107",
            "telephone_number": "757-227-3072",
            "fax_number": "757-227-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PERSONAL GROWTH & CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SLOAN",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "757-227-3072"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.