Creative Change Counseling, Inc.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

CREATIVE CHANGE COUNSELING, INC.

Practice address

322 E 5TH St
Lakewood, NJ 08701-3415

Phone

(609) 577-4310

Fax

(609) 667-7944

NPI assigned

Apr 15, 2021

Organization subpart

Yes

Parent organization

CREATIVE CHANGE COUNSELING, INC.As reported in NPPES

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

Specialties & licenses 1

Addresses

Other names 1

• One Day at A Time WF-SAI Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Creative Change Counseling

  • Substance Abuse Rehabilitation Facility
  • Lumberton, NJ
  • NPI 1235795014

  O20211011000372

  Same enrollment
• Creative Change Counseling

  • Adolescent and Children Mental Health Clinic/Center
  • Lumberton, NJ
  • NPI 1841813722

  O20211011000372

  Same enrollment

Part of

Creative Change Counseling

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ngozi Attracta Ochiora

  • Psychiatric/Mental Health Nurse Practitioner
  • Mount Holly, NJ
  • NPI 1699349399
  NPD
• Caroline Washington, MSW, LCSW

  • Clinical Social Worker
  • Trenton, NJ
  • NPI 1467623223
  NPD

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"
        }
    ]
}

• Robert Cranley, MD
• Karen Lynn Craven, OTR L
• Creative Care Therapy
• Creative Change Counseling, Inc.
• 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

• All providers in Lakewood, NJ
• Substance Use Disorder Rehabilitation Clinic/Center in New Jersey

• 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.

Verify at the official NPI Registry.