CREATIVE CHANGE COUNSELING (NPI# 1023643947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023643947 |
| Entity Type | Organization |
| Organization Name | CREATIVE CHANGE COUNSELING |
| Practice Address |
10504 Bruton Rd Dallas TX 75217-3105 |
| Practice Telephone | 2147720226 |
| Practice Fax Number | 9727673471 |
| Mailing Telephone | 2147720226 |
| Mailing Fax Number | 9727673471 |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2020-03-11 |
| Authorized Official Name | CRYSTAL LOPEZ (OWNER) |
| Authorized Official Telephone | 3189321463 |
| Is Organization Subpart | Y |
| Parent Organization Name | CL COUNSELING PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Creative Change Counseling | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841813722 | Creative Change Counseling | Clinic/Center | 774 Eayrestown Rd Ste 204, Lumberton, NJ 08048-3100 | 2020-05-26 |
| 1235795014 | Creative Change Counseling | Substance Abuse Rehabilitation Facility | 774 Eayrestown Rd Ste 204, Lumberton, NJ 08048-3100 | 2019-05-16 |
| 1053794065 | Creative Change Counseling | Psychologist | 774 Eayrestown Rd, Suite 204, Lumberton, NJ 08048-3100 | 2015-07-08 |
| 1033367131 | Creative Change Counseling | Community/Behavioral Health | 1600 Dexter Ave N, Suite C-5, Seattle, WA 98109-3079 | 2008-09-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CREATIVE CHANGE COUNSELING A NJ NONPROFIT CORPORATION | 774 Eayrestown Road, Suite 204, Lumberton, NJ 08048-3100 |
| Washington State Corporations | CREATIVE CHANGE COUNSELING CENTER, P.C. | 200 S Tobin St #a, Renton, WA 98057 |
| Street Address |
10504 BRUTON RD |
| City | DALLAS |
| State | TX |
| Zip Code | 75217-3105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114558756 | Chance2change | Counselor | 10504 Bruton Rd, Dallas, TX 75217-3105 | 2020-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437708682 | Nancy Sutton | Technician | 9335 Homeplace Dr, Dallas, TX 75217 | 2019-09-10 |
| 1194135236 | Phat Dien Truong | Student in an Organized Health Care Education/Training Program | 9709 Bruton Rd., Dallas, TX 75217 | 2014-04-29 |
| 1083039226 | Passage of Youth Family Center, Inc. | Exclusive Provider Organization | 1623 Riverway, Dallas, TX 75217 | 2014-02-25 |
| 1649511270 | First Class Motors Inc. | Private Vehicle | 7710 Great Trinity Forest Way #k, Dallas, TX 75217 | 2013-03-06 |
| 1588969893 | Happy Teeth Dental Centers of Dallas PC | Dentist | 2020 N Masters Dr Suite #100, Dallas, TX 75217 | 2011-01-18 |
| 1891934899 | Shapa Inc | Pharmacy | 9415 Bruton Rd, Ste 3103, Dallas, TX 75217 | 2009-02-13 |
| 1033364450 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 10152 Lake June Rd, Dallas, TX 75217 | 2008-11-26 |
| 1326268533 | Eyad K. Mahrouq | Pharmacist | 1515 S. Buckner Blvd #301, Dallas, TX 75217 | 2007-04-27 |
| 1598886822 | Lake June Medical Center, P.a. | Family Medicine | 7716 Lake June Road, Dallas, TX 75217 | 2007-04-03 |
| 1194869636 | Barbara Jean Cole | Assisted Living Facility | 1364 Gillette St, Dallas, TX 75217 | 2007-02-17 |
| Find all providers in zip 75217 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447786793 | Nothing Just Happens Incorporated | Clinic/Center | 1618 Driftwood Dr, Dallas, TX 75224-3705 | 2017-05-05 |
| 1184054843 | Holman Family Services | Clinic/Center | 2705 Swiss Ave Ste 110, Dallas, TX 75204-5923 | 2013-11-17 |
| 1871735373 | Noelle K. Mcdonald, Ph.d. | Clinic/Center | 6350 Lyndon B Johnson Fwy Ste 151, Dallas, TX 75240-6408 | 2009-03-30 |
| 1225297633 | Hope Community Support | Clinic/Center | 1012d Philadelphia Church Rd, Dallas, NC 28034-7684 | 2008-06-02 |
| 1740477280 | Juliette Fowler Homes, Inc. | Clinic/Center | 1234 Abrams Rd, Dallas, TX 75214-4850 | 2007-09-28 |
| 1336266733 | Alexander Youth Network | Clinic/Center | 1904 Dallas Cherryville Hwy, Dallas, NC 28034-7706 | 2007-03-23 |
| 1366082240 | Carbery Center for Child Development Pllc | Clinic/Center | 6060 N Central Expy Ste 222, Dallas, TX 75206-5318 | 2020-01-08 |
| 1528529625 | Empowered Maturity Pllc | Clinic/Center | 13355 Noel Rd Ste 1100, Dallas, TX 75240-6694 | 2019-03-29 |
| 1346705449 | Copenhagen Counseling, Pllc | Clinic/Center | 10300 N Central Expy Ste 280, Dallas, TX 75231-8666 | 2019-02-04 |
| 1144707977 | Dream Education Consulting | Clinic/Center | 1409 S Lamar St Apt 307, Dallas, TX 75215-6819 | 2018-07-24 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.