Creative Healing Space, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CREATIVE HEALING SPACE, LLC

Practice address

235 Emmett St
Fall River, MA 02721-3523

Phone

(774) 264-3481

NPI assigned

Jan 4, 2024

Organization subpart

No

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

Authorized official

Name

Jessica Baraby, LICSWNPI 1679039705

Title

Owner

Phone

(774) 264-1249

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 2

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

• Jessica Baraby

  • Mental Health Counselor
  • Fall River, MA
  • NPI 1679039705
  Medicare reassignment Care Compare group NPD Authorized official
• Jessica Lyn Gagne-Griffin, LMHC

  • Mental Health Counselor
  • Fall River, MA
  • NPI 1407464076
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1174393771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 STATE RD",
            "address_2": "UNIT 11 #126",
            "city": "WESTPORT",
            "state": "MA",
            "postal_code": "027902853",
            "telephone_number": "774-264-3481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 EMMETT ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027213523",
            "telephone_number": "774-264-3481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE HEALING SPACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "BARABY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "774-264-1249",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "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": []
}

• Gregory Robert Cowan, LMHC
• Amanda Craig
• Robert S Crausman, M.D.
• Christine Crawford, LSW, M.ED.
• Virginia Creamer, MSW
• Cristina'S Home Care LLC
• Darlene Crombie
• Kellie Marie Cronin
• Mary Elizabeth Cronin, RN, PMHNP-BC
• Michael J Crooks, M.A.

• Mental Health Counselor in Fall River, MA
• Providers in Fall River, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.