NPIMap

Organization Active NPI

Conditions for Change LLC

Doing business as Mindful Psychotherapy & Trauma Resolution

  • Mental Health Counselor
  • Glenmoore, PA
National Provider Identifier
1164986121
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CONDITIONS FOR CHANGE LLC
Doing business as
Mindful Psychotherapy & Trauma Resolution
Mindful Worldly Path Coaching
Practice address
35 Brook Cir
Glenmoore, PA 19343-1204
Phone
(610) 427-0698
NPI assigned
Jan 24, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Authorized official

Name
Ms. Jennifer Lee Erickson, LPCNPI 1528200037
Title
Owner
Phone
(610) 427-0698

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary
Health & Wellness CoachGroup: 193200000X MULTI-SPECIALTY GROUP 171400000X

Addresses

Primary practice location

35 Brook Cir
Glenmoore, PA 19343-1204

Mailing address

35 Brook Cir
Glenmoore, PA 19343-1204
Phone (610) 427-0698

Other names 2

  • Mindful Psychotherapy & Trauma Resolution Doing business as
  • Mindful Worldly Path Coaching Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1164986121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 BROOK CIR",
            "city": "GLENMOORE",
            "state": "PA",
            "postal_code": "193431204",
            "telephone_number": "610-427-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 BROOK CIR",
            "city": "GLENMOORE",
            "state": "PA",
            "postal_code": "193431204",
            "telephone_number": "610-427-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONDITIONS FOR CHANGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-24",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-427-0698",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindful Psychotherapy & Trauma Resolution",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mindful Worldly Path Coaching",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glenmoore, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.