Healthcare Provider Details

I. General information

NPI: 1306827357
Provider Name (Legal Business Name): METHODS OF CHANGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 03/05/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1170 GULF BLVD. APT. 206
CLEARWATER FL
33767
US

IV. Provider business mailing address

420 E 51ST STREET APT. 7A
NEW YORK NY
10022
US

V. Phone/Fax

Practice location:
  • Phone: 973-981-5003
  • Fax: 973-595-5312
Mailing address:
  • Phone: 973-981-5003
  • Fax: 973-595-5312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number37F100150400
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT2060
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. LOUIS JOSEPH SCURTI
Title or Position: THERAPIST
Credential: PH.D., LMFT
Phone: 973-981-5003