Healthcare Provider Details

I. General information

NPI: 1245178862
Provider Name (Legal Business Name): CHANGE OF HEART COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MERCHANTS WAY
COLTS NECK NJ
07722-1552
US

IV. Provider business mailing address

25 MERCHANTS WAY
COLTS NECK NJ
07722-1552
US

V. Phone/Fax

Practice location:
  • Phone: 732-996-9797
  • Fax:
Mailing address:
  • Phone: 732-996-9797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROSALIND FRANCES PAGLIANO
Title or Position: SOLE MEMBER
Credential: LPC
Phone: 732-996-9797