NPIMap

Organization Active NPI

Counseling for Change: a Psychological Corporation

Doing business as Counseling for Change

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Mateo, CA
National Provider Identifier
1174077069
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
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
Doing business as
Counseling for Change
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
Last updated
Aug 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Authorized official

Name
Robert A. Williams, PH.D.NPI 1669614723
Title
President & Psychologist
Phone
(415) 509-6734

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 21573 CA Primary

Addresses

Primary practice location

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

Mailing address

1100 S El Camino Real Ste 1
San Mateo, CA 94402-2880
Phone (415) 509-6734

Other names 1

  • Counseling for Change Doing business as

National Provider Directory

National Provider Directory

Locations

1100 S El Camino Real
Ste 1
San Mateo, CA 94402
Phone (415) 509-6734

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "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"
        }
    ]
}

Other providers in San Mateo, CA

Sources for this page

  • 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.