CREATIVE CHANGE COUNSELING NPI 1053794065

NPI Information

NPI: 1053794065
Provider Name: CREATIVE CHANGE COUNSELING
Classification: Clinic/Center - 261QM0801X
Specialization: Mental Health (Including Community Mental Health Center)
Entity Type: Organization
Address: 423 7TH AVE SW
HICKORY, NC
ZIP 28602
Phone: (609) 668-4719

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NPI Details

CREATIVE CHANGE COUNSELING is a mental health (including community mental health center) clinic center in Hickory, NC. CREATIVE CHANGE COUNSELING NPI is 1053794065. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

423 7TH AVE SW
HICKORY, NC
ZIP 28602-237
Phone: (609) 668-4719

The provider's authorized official is Bertee Thomas .
The authorized official title is Program Operations Executive Direct and has the following contact phone number (609) 668-4719.

The enumeration date for this NPI number is 7/8/2015 and was last updated on 5/15/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	103TC1900X	Psychologist	Counseling	NEW JERSEY	No
2	251S00000X	Community/Behavioral Health			No
3	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0506460	MEDICAID	NEW JERSEY
2	1053794065	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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