NPIMap

Organization Active NPI

Creative Alternatives for Psychological Growth LLC

  • Community/Behavioral Health Agency
  • Woodstock, IL
National Provider Identifier
1063724771
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
071006683 Issued in IL
Legal business name
CREATIVE ALTERNATIVES FOR PSYCHOLOGICAL GROWTH LLC
Practice address
645 McHenry Ave
Woodstock, IL 60098-2922
Phone
(815) 245-6669
NPI assigned
Jul 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Authorized official

Name
Dr. Kelly Vinehout, PSYDNPI 1134263999
Title
Clinical Psychologist
Phone
(815) 245-6669

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 071006683 IL Primary

Addresses

Primary practice location

645 McHenry Ave
Woodstock, IL 60098-2922

Mailing address

PO Box 1861
Woodstock, IL 60098-1861
Phone (815) 245-6669

Other identifiers 4

IdentifierTypeStateIssuer
2201382OtherILCOMPSYCH
600016110OtherILMAGELLAN
11894012OtherILCAQH
35641736OtherILBCBS

National Provider Directory

National Provider Directory
Tax ID family
Creative Alternatives for Psychological Growth LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284422400000",
    "number": "1063724771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1861",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600981861",
            "telephone_number": "815-245-6669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 MCHENRY AVE",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600982922",
            "telephone_number": "815-245-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE ALTERNATIVES FOR PSYCHOLOGICAL GROWTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-10",
        "last_updated": "2010-09-14",
        "status": "A",
        "authorized_official_last_name": "VINEHOUT",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "815-245-6669",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "071006683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "2201382",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "600016110",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11894012",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "35641736",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.