Active NPI
Creative Change Counseling, Inc.
Doing business as One Day at A Time WF-SAI
- Substance Use Disorder Rehabilitation Clinic/Center
- Lakewood, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/Center
- Legal business name
- CREATIVE CHANGE COUNSELING, INC.
- Doing business as
- One Day at A Time WF-SAI
- Practice address
- 322 E 5TH St
Lakewood, NJ 08701-3415 - Phone
- (609) 577-4310
- Fax
- (609) 667-7944
- NPI assigned
- Apr 15, 2021
- Last updated
- Apr 15, 2021
- Organization subpart
- Yes
- Parent organization
- CREATIVE CHANGE COUNSELING, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Bertee Thomas Jr., PSY.D.
- Title
- Ceo
- Phone
- (609) 668-4719
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | Primary |
Addresses
Primary practice location
322 E 5TH St
Lakewood, NJ 08701-3415
Mailing address
774 Eayrestown Rd Ste 204
Lumberton, NJ 08048-3100
Phone (609) 668-4719
Other names 1
- One Day at A Time WF-SAI
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211011000372 | NJ | Part B Supplier - Clinic/Group Practice | 9739587486 |
Receives reassigned benefits from 4 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lumberton, NJ; Southampton, NJ; Lakewood, NJ |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Substance Abuse Rehabilitation Facility
- Lumberton, NJ
- NPI 1235795014
O20211011000372
-
- Adolescent and Children Mental Health Clinic/Center
- Lumberton, NJ
- NPI 1841813722
O20211011000372
National Provider Directory
National Provider Directory- Part of
- Creative Change Counseling
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Professional Counselor
- Lumberton, NJ
- NPI 1649627431
-
- Psychiatric/Mental Health Nurse Practitioner
- Mount Holly, NJ
- NPI 1699349399
-
- Clinical Social Worker
- Trenton, NJ
- NPI 1467623223
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618444800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1618444800000",
"number": "1861073504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "774 EAYRESTOWN RD STE 204",
"city": "LUMBERTON",
"state": "NJ",
"postal_code": "080483100",
"telephone_number": "609-668-4719"
},
{
"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": "609-577-4310",
"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": "2021-04-15",
"last_updated": "2021-04-15",
"certification_date": "2021-03-22",
"status": "A",
"authorized_official_last_name": "THOMAS",
"authorized_official_first_name": "BERTEE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "609-668-4719",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "PSY.D."
},
"taxonomies": [
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "One Day at A Time WF-SAI",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Lakewood, NJ
- Robert Cranley, MD
- Karen Lynn Craven, OTR L
- Creative Care Therapy
- Creative Change Counseling, Inc. (One Day at A Time)
- Creative Change Counseling, Inc.
- Creative Therapy Resources
- Douglas Elliott Cresson, MSW, LSW
- Crest Lakewood Physical Therapy LLC
- Crisp Speech Therapy LLC
- Critical Concepts Services, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.