Counseling for Change: a Psychological Corporation

Primary specialty

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

License

21573 Issued in CA

Legal business name

COUNSELING FOR CHANGE: A PSYCHOLOGICAL CORPORATION

Practice address

1100 S El Camino Real Ste 1
San Mateo, CA 94402-2880

Phone

(415) 509-6734

Fax

(415) 668-5996

NPI assigned

Aug 8, 2016

Organization subpart

No

Name

Robert A. Williams, PH.D.

Title

President & Psychologist

Phone

(415) 509-6734

Locations

• Counseling for Change Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 8, 2016.

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470614400000",
    "number": "1174077069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S EL CAMINO REAL STE 1",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022880",
            "telephone_number": "415-509-6734",
            "fax_number": "415-668-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S EL CAMINO REAL STE 1",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022880",
            "telephone_number": "415-509-6734",
            "fax_number": "415-668-5996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING FOR CHANGE: A PSYCHOLOGICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-08",
        "last_updated": "2016-08-08",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT & PSYCHOLOGIST",
        "authorized_official_telephone_number": "415-509-6734",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CA",
            "license": "21573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Counseling for Change",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephen Costakis
• Christian Cotton
• Jeanie Elizabeth Cotton, LMFT, MS
• Shawn Michael Cotton
• Alyssa Gianella Coulter
• County of San Mateo
• County of San Mateo
• County of San Mateo
• County of San Mateo
• County of San Mateo

• All providers in San Mateo, CA
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; 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.