Conscious Change Mental Health Counseling Services PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CONSCIOUS CHANGE MENTAL HEALTH COUNSELING SERVICES PLLC

Practice address

184 Gurley Ave
Staten Island, NY 10308-1505

Phone

(929) 260-1363

NPI assigned

Jan 24, 2025

Organization subpart

No

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

Authorized official

Name

Jane PeckNPI 1477107597

Title

Owner/Provider

Phone

(929) 260-1363

Specialties & licenses 1

Addresses

Other names 1

• Conscious Change Mental Health Counseling Services PLLC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jane Peck

  • Mental Health Counselor
  • Staten Island, NY
  • NPI 1477107597
  NPD Authorized official

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

{
    "created_epoch": "1737676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737676800000",
    "number": "1093527111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 GURLEY AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103081505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 GURLEY AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103081505",
            "telephone_number": "929-260-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSCIOUS CHANGE MENTAL HEALTH COUNSELING SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-24",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "929-260-1363"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conscious Change Mental Health Counseling Services PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barbara Ann Connors, MA CCC-SLP
• Katherine Anne Connors, P.T.
• Anthony Gerard Conrad Jr., P.A
• Carol Conroy, SLP
• Marissa Ann Conroy, M.S. CCC-SLP
• Robert Considine, LCSW
• Elaina Consiglio, PA-C
• Jessica L Consolmagno, PA-C
• Consortium Home Care Inc
• Betty Marie Constant, NP

• Mental Health Counselor in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; 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.