Organization Active NPI

Growth and Change Counseling Inc

  • Marriage & Family Therapist
  • Roseville, CA
National Provider Identifier
1487379285
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
GROWTH AND CHANGE COUNSELING INC
Practice address
1700 Eureka Rd Ste 155-10
Roseville, CA 95661-7720
Phone
(408) 461-9658
NPI assigned
Oct 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
John Kane, LMFTNPI 1376712174
Title
Owner
Phone
(408) 461-9658

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

1700 Eureka Rd Ste 155-10
Roseville, CA 95661-7720

Mailing address

1700 Eureka Rd Ste 155-10
Roseville, CA 95661-7720
Phone (916) 237-7052

Other practice location 1

1849 Sawtelle Blvd Ste 610
Los Angeles, CA 90025-7013
Phone (408) 692-6921

Other practice location 2

1875 S Bascom Ave Ste 2400
Campbell, CA 95008-2356
Phone (408) 461-9658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240806000330 MO Part B Supplier - Clinic/Group Practice 0143662122 Receives reassigned benefits from 1 practitioner
Practice locations: Branson, MO

National Provider Directory

National Provider Directory

Locations

1875 S Bascom Ave
Ste 2400
Campbell, CA 95008
Phone (408) 461-9658

409 Tennant Sta
Morgan Hill, CA 95037
Phone (408) 659-0111

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": "1664928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1487379285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 EUREKA RD STE 155-10",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956617720",
            "telephone_number": "916-237-7052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 EUREKA RD STE 155-10",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956617720",
            "telephone_number": "408-461-9658"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1849 Sawtelle Blvd Ste 610",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900257013",
            "country_code": "US",
            "telephone_number": "408-692-6921",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1875 S Bascom Ave Ste 2400",
            "address_purpose": "LOCATION",
            "city": "Campbell",
            "state": "CA",
            "postal_code": "950082356",
            "country_code": "US",
            "telephone_number": "408-461-9658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GROWTH AND CHANGE COUNSELING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-05",
        "last_updated": "2024-04-18",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "KANE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-461-9658",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.