NPIMap

Organization Active NPI

Creative Change Counseling, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lakewood, NJ
National Provider Identifier
1508437179
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CREATIVE CHANGE COUNSELING, INC.
Practice address
322 E 5TH St
Lakewood, NJ 08701-3415
Phone
(609) 668-4719
Fax
(609) 667-7944
NPI assigned
Jul 6, 2021
Last updated
Jul 6, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
CREATIVE CHANGE COUNSELING, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Authorized official

Name
Bertee Thomas, PSY. D., LPCNPI 1649627431
Title
Ceo
Phone
(609) 667-7353

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 NU Primary

Addresses

Primary practice location

322 E 5TH St
Lakewood, NJ 08701-3415

Mailing address

668 Main St
Lumberton, NJ 08048-5016
Phone (609) 668-4719

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL bthomas@creativechangeinc.org Other

National Provider Directory

National Provider Directory
Tax ID family
Creative Change Counseling14 organizations share this tax ID, including this one
Part of
Creative Change Counseling

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

322 E 5th St
Lakewood, NJ 08701
Phone (609) 577-4310

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": "1625529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625529600000",
    "number": "1508437179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 MAIN ST",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "080485016",
            "telephone_number": "609-668-4719",
            "fax_number": "609-667-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 E 5TH ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087013415",
            "telephone_number": "609-668-4719",
            "fax_number": "609-667-7944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE CHANGE COUNSELING, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CREATIVE CHANGE COUNSELING, INC.",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "BERTEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-667-7353",
        "authorized_official_credential": "PSY. D., LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "bthomas@creativechangeinc.org",
            "affiliation": "N",
            "endpointDescription": "e-mail",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "bthomas@creativechangeinc.org",
            "address_1": "322 E 5th St",
            "city": "Lakewood",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "087013415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.