MEDICARE: CREATIVE CHANGE COUNSELING, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1508437179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREATIVE CHANGE COUNSELING, INC.

Provider Business Mailing Address
First Line	:	668 MAIN ST
Second Line	:
City	:	LUMBERTON
State	:	NJ
Zip	:	08048-5016
Country	:	US
Telephone Number	:	609-668-4719
Fax Number	:	609-667-7944

Provider Business Practice Location Address
First Line	:	322 E 5TH ST
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-3415
Country	:	US
Telephone Number	:	609-668-4719
Fax Number	:	609-667-7944

Authorized Official
Title or Position	:	CEO
Name	:	BERTEE THOMAS
Credential	:	PSY. D., LPC
Telephone Number	:	609-667-7353

Provider Enumeration Date	:	07/06/2021
Last Update Date	:	07/06/2021

Similar Medicare Providers

1407432321 — CREATIVE CHANGE COUNSELING, INC.
Practice Location Address:

322 E 5TH ST
LAKEWOOD, NJ
08701-3415

Practice Phone: 609-668-4719
Practice Fax: 609-667-7944

1861073504 — CREATIVE CHANGE COUNSELING, INC.
Practice Location Address:

322 E 5TH ST
LAKEWOOD, NJ
08701-3415

Practice Phone: 609-577-4310
Practice Fax: 609-667-7944

1598600827 — JEROME ROBINSON ED.S, LPC, LCADC
Practice Location Address:

322 E 5TH ST
LAKEWOOD, NJ
08701-3415

Practice Phone: 609-577-4310
Practice Fax: 609-371-8481

1528991585 — JON RESTIVO
Practice Location Address:

600 RIVER AVE
LAKEWOOD, NJ
08701-5237

Practice Phone: 848-480-9671
Practice Fax:

1972436913 — EPHRAIM NUSSBAUM
Practice Location Address:

1935 SWARTHMORE AVE
LAKEWOOD, NJ
08701-4565

Practice Phone: 732-966-4926
Practice Fax:

1154254035 — JAMES HERNDON
Practice Location Address:

850 TOWBIN AVE
LAKEWOOD, NJ
08701-5928

Practice Phone: 866-523-4268
Practice Fax:

Directions to “CREATIVE CHANGE COUNSELING, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.