Courage to Change, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37PC00457200 Issued in NJ

Legal business name

COURAGE TO CHANGE, LLC

Practice address

215 Highland Ave Ste C
Haddon Township, NJ 08108-2634

Phone

(856) 854-3155

Fax

(856) 854-0992

NPI assigned

Apr 25, 2018

Last updated

Jul 30, 2024By 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

Carol Bakey, LPC, LCADC

Title

Owner/Sole Member

Phone

(856) 854-3155

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1821586843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 N DELSEA DR UNIT B",
            "city": "CLAYTON",
            "state": "NJ",
            "postal_code": "083121637",
            "telephone_number": "856-423-7700",
            "fax_number": "856-423-0823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 HIGHLAND AVE STE C",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081082634",
            "telephone_number": "856-854-3155",
            "fax_number": "856-854-0992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COURAGE TO CHANGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-25",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "BAKEY",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "OWNER/SOLE MEMBER",
        "authorized_official_telephone_number": "856-854-3155",
        "authorized_official_credential": "LPC, LCADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00182400",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00457200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.