Advanced Counseling for Change, PLLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

2645 Issued in ND

Legal business name

ADVANCED COUNSELING FOR CHANGE, PLLC

Practice address

424 3Rd St SE
Devils Lake, ND 58301-3605

Phone

(701) 351-1182

Fax

(701) 662-6234

NPI assigned

Feb 23, 2009

Last updated

Feb 23, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa R Hawley, LICSWNPI 1891996179

Title

Director/Owner

Phone

(701) 351-1182

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Locations

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.

• Lisa Ruth Hawley, LICSW

  • Social Worker
  • Devils Lake, ND
  • NPI 1891996179
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235347200000",
    "number": "1700026317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 3RD ST SE",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583013605",
            "telephone_number": "701-351-1182",
            "fax_number": "701-662-6234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 3RD ST SE",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583013605",
            "telephone_number": "701-351-1182",
            "fax_number": "701-662-6234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED COUNSELING FOR CHANGE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-02-23",
        "status": "A",
        "authorized_official_last_name": "HAWLEY",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "701-351-1182",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ND",
            "license": "2645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Devils Lake, ND by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; 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.