| Creative Change Counseling | |
|
423 7th Ave Sw Hickory NC 28602-3237 | |
| (609) 668-4719 | |
| Not Available |
| Full Name | Creative Change Counseling |
|---|---|
| Speciality | Clinic/Center |
| Location | 423 7th Ave Sw, Hickory, North Carolina |
| Authorized Official Name and Position | Bertee Thomas (PROGRAM OPERATIONS EXECUTIVE DIRECT) |
| Authorized Official Contact | 6096684719 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Change Counseling 774 Eayrestown Rd Suite 204 Lumberton NJ 08048-3100 Ph: (609) 668-4719 | Creative Change Counseling 423 7th Ave Sw Hickory NC 28602-3237 Ph: (609) 668-4719 |
| NPI Number | 1053794065 |
|---|---|
| Provider Enumeration Date | 07/08/2015 |
| Last Update Date | 05/15/2022 |
| Certification Date | 05/15/2022 |
| Medicare PECOS PAC ID | 9739587486 |
|---|---|
| Medicare Enrollment ID | O20240202001434 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053794065 | NPI | - | NPPES |
| 0506460 | Medicaid | NJ | |
| 1053794065 | Medicaid | NC |
| Provider Name | Laurie Ann George |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740885185 PECOS PAC ID: 1254779150 Enrollment ID: I20240410001836 |
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