NPIMap

Organization Active NPI

Creative Counseling Services

  • Clinical Social Worker
  • Connersville, IN
National Provider Identifier
1154488773
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34004224A Issued in IN
Legal business name
CREATIVE COUNSELING SERVICES
Practice address
1956 Ohio Ave
Connersville, IN 47331-2858
Phone
(765) 827-5610
Fax
(765) 825-9440
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Mrs. Debra K. Shain, LCSW
Title
Clinical Social Worker
Phone
(765) 827-5610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 34004224A IN Primary

Addresses

Primary practice location

1956 Ohio Ave
Connersville, IN 47331-2858

Mailing address

1956 Ohio Ave
Connersville, IN 47331-2858
Phone (765) 827-5610

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1154488773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1956 OHIO AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473312858",
            "telephone_number": "765-827-5610",
            "fax_number": "765-825-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1956 OHIO AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473312858",
            "telephone_number": "765-827-5610",
            "fax_number": "765-825-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "SHAIN",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "765-827-5610",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004224A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Connersville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.