Center for Positive Change LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

CENTER FOR POSITIVE CHANGE LLC

Practice address

1136 Water St Ste 105
Port Townsend, WA 98368-6728

Phone

(360) 385-1030

Fax

(775) 243-9945

NPI assigned

Nov 29, 2018

Last updated

Nov 29, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Timothy David Berry, PH.D.NPI 1972623411

Title

President

Phone

(360) 385-1030

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Locations

Practitioners 6

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.

• Timothy D. Berry, PH.D.

  • Psychologist
  • Missoula, MT
  • NPI 1972623411

  Clinical

  Medicare reassignment Care Compare group NPD Authorized official
• Autumn L. Berry, LCSW

  • Clinical Social Worker
  • Missoula, MT
  • NPI 1922864446
  Medicare reassignment Care Compare group NPD
• Mark Ferriter, MSW, L.C.S.W.

  • Clinical Social Worker
  • Missoula, MT
  • NPI 1700283439
  NPD
• John Lawrence Cowden, LCPC

  • Mental Health Counselor
  • Missoula, MT
  • NPI 1366373979
  NPD (past)
• Maria Lee, LCSW

  • Clinical Social Worker
  • Missoula, MT
  • NPI 1477041671
  NPD (past)
• Ryan Winn

  • Mental Health Counselor
  • Missoula, MT
  • NPI 1548102411
  NPD (past)

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543449600000",
    "number": "1063982247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 WATER ST STE 105",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983686728",
            "telephone_number": "360-385-1030",
            "fax_number": "775-243-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 WATER ST STE 105",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983686728",
            "telephone_number": "360-385-1030",
            "fax_number": "775-243-9945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR POSITIVE CHANGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-29",
        "last_updated": "2018-11-29",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-385-1030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cascade Medical Investors Limited Partnership (Life Care Center of Port Townsend)
• Jovanna Pia Casey, MSW LMHC
• Jennifer Cashin, CN
• Gina Casillas
• Gabrhea Caudill, SUDP, LMHC
• Central Physical Therapy and Fitness, P.S.C. (Central Physical Therapy)
• Claire M Chambers, LMHC
• Tom Mack Chambers
• Heide Lynn Chaney, ARNP
• Mark Cherniack, MSW

• Clinical Psychologist in Port Townsend, WA
• Providers in Port Townsend, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.