NPIMap

Organization Active NPI

Creative Change Counseling Center

  • Community/Behavioral Health Agency
  • Renton, WA
National Provider Identifier
1811200173
Registry record updated Jul 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
17149100 Issued in WA
Legal business name
CREATIVE CHANGE COUNSELING CENTER
Practice address
220 SW Blvd.
Suite B102
Renton, WA 98057-4158
Phone
(425) 255-5526
Fax
(425) 255-5523
NPI assigned
Jul 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2010

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

Authorized official

Name
Ms. Forest Edwin Woodley, AFFILIATED COUNSELOR
Title
Ceo
Phone
(425) 255-5526

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 221 WA
Community/Behavioral Health Agency 251S00000X 17149100 WA Primary

Addresses

Primary practice location

220 SW Blvd.
Suite B102
Renton, WA 98057-4158

Mailing address

PO Box 4158
Renton, WA 98057-4158
Phone (425) 255-5526

National Provider Directory

National Provider Directory
Tax ID family
Creative Change Counseling Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279152000000",
    "number": "1811200173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4158",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574158",
            "telephone_number": "425-255-5526",
            "fax_number": "425-255-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SW BLVD.",
            "address_2": "SUITE B102",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574158",
            "telephone_number": "425-255-5526",
            "fax_number": "425-255-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE CHANGE COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-15",
        "last_updated": "2010-07-15",
        "status": "A",
        "authorized_official_last_name": "WOODLEY",
        "authorized_official_first_name": "FOREST",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "425-255-5526",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "AFFILIATED COUNSELOR"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "WA",
            "license": "221",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": "17149100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.