Organization Active NPI

Changes a Psychotherapeutic Practice

  • Clinical Social Worker
  • Linwood, NJ
National Provider Identifier
1508074774
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC01453300 Issued in NJ
Legal business name
CHANGES A PSYCHOTHERAPEUTIC PRACTICE
Practice address
505 Hamilton Ave
Suite 103
Linwood, NJ 08221-1057
Phone
(609) 653-0665
Fax
(609) 926-8697
NPI assigned
May 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Thomas Altaffer, LCSWNPI 1174731343
Title
Owner
Phone
(609) 653-0665

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 44SC01453300 NJ Primary

Addresses

Primary practice location

505 Hamilton Ave
Suite 103
Linwood, NJ 08221-1057

Mailing address

411 W Edgewood Ave
Linwood, NJ 08221-1709
Phone (609) 653-0665

Other identifiers 1

IdentifierTypeStateIssuer
7704433OtherNJAETNA

National Provider Directory

National Provider Directory

Locations

505 Hamilton Ave
Ste 103
Linwood, NJ 08221
Phone (609) 653-0665

Practitioners & affiliated clinicians

Practitioners 2

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": "1179532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508074774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W EDGEWOOD AVE",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211709",
            "telephone_number": "609-653-0665",
            "fax_number": "609-926-8697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 HAMILTON AVE",
            "address_2": "SUITE 103",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211057",
            "telephone_number": "609-653-0665",
            "fax_number": "609-926-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGES A PSYCHOTHERAPEUTIC PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALTAFFER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-653-0665",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC01453300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7704433",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Linwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.