Cr8Tive Mindz

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CR8TIVE MINDZ

Practice address

1777 N Bellflower Blvd Ste 105
Long Beach, CA 90815-4019

Phone

(323) 402-1803

NPI assigned

Sep 1, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kandice GrayNPI 1396016903

Title

Ceo/Co-Founder, LCSW

Phone

(310) 654-7485

Specialties & licenses 4

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kandice Dominique Gray

  • Clinical Social Worker
  • Long Beach, CA
  • NPI 1396016903
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661990400000",
    "number": "1023738739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 W 3RD ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312506",
            "telephone_number": "323-402-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 N BELLFLOWER BLVD STE 105",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908154019",
            "telephone_number": "323-402-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CR8TIVE MINDZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "KANDICE",
        "authorized_official_title_or_position": "CEO/CO-FOUNDER, LCSW",
        "authorized_official_telephone_number": "310-654-7485"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillian Cox
• Roger Cox
• Shanna R Cox, M.D.
• Maria Magdalena Coyle, LVN
• Virginia Coyle, PSY.D.
• Julia Craddolph
• Michael Crade, M.D.
• Elana Craemer, M.D.
• Craig Kain, PHD, Psychological Services, Apc
• Gloria Perez Craig, NP

• Community/Behavioral Health Agency in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.