The Behavioral Change Clinic PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

THE BEHAVIORAL CHANGE CLINIC PLLC

Practice address

200 E Big Beaver Rd
Troy, MI 48083-1208

Phone

(248) 564-1183

Fax

(248) 458-4578

NPI assigned

Oct 7, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Dominic Christopher Moceri, PHD

Title

President, Clinical Psychologist

Phone

(248) 564-1183

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595203200000",
    "number": "1073154407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E BIG BEAVER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831208",
            "telephone_number": "248-564-1183",
            "fax_number": "248-458-4578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E BIG BEAVER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831208",
            "telephone_number": "248-564-1183",
            "fax_number": "248-458-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BEHAVIORAL CHANGE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-07",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A",
        "authorized_official_last_name": "MOCERI",
        "authorized_official_first_name": "DOMINIC",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT, CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "248-564-1183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Troy, MI
• Providers in Troy, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.