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Organization
CREATIVE CHANGE COUNSELING
Active
Organization
CREATIVE CHANGE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERTEE THOMAS (CEO)
(609) 667-7353
Entity
Organization
Contact information
Practice address
774 EAYRESTOWN RD STE 204, LUMBERTON, NJ 08048-3100
(609) 668-4719
Mailing address
774 EAYRESTOWN RD STE 204, LUMBERTON, NJ 08048-3100
(609) 668-4719
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/26/2020
Last updated
05/26/2020
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