| Courage To Change, Llc | |
|
215 Highland Ave Ste C Haddon Township NJ 08108-2634 | |
| (856) 854-3155 | |
| (856) 854-0992 |
| Full Name | Courage To Change, Llc |
|---|---|
| Speciality | Counselor |
| Location | 215 Highland Ave Ste C, Haddon Township, New Jersey |
| Authorized Official Name and Position | Carol Bakey (OWNER/SOLE MEMBER) |
| Authorized Official Contact | 8568543155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Courage To Change, Llc 23 N Delsea Dr Unit B Clayton NJ 08312-1637 Ph: (856) 423-7700 | Courage To Change, Llc 215 Highland Ave Ste C Haddon Township NJ 08108-2634 Ph: (856) 854-3155 |
| NPI Number | 1821586843 |
|---|---|
| Provider Enumeration Date | 04/25/2018 |
| Last Update Date | 07/30/2024 |
| Certification Date | 07/30/2024 |
| Medicare PECOS PAC ID | 1153770193 |
|---|---|
| Medicare Enrollment ID | O20240209003117 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821586843 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 37LC00182400 (New Jersey) | Secondary |
| 101YP2500X | Counselor - Professional | 37PC00457200 (New Jersey) | Primary |
| Provider Name | Carol Bakey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982857975 PECOS PAC ID: 9436508470 Enrollment ID: I20240209003309 |
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