Creekside Psychiatric Center PA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CREEKSIDE PSYCHIATRIC CENTER PA

Practice address

5190 Bayou Blvd Ste 6
Pensacola, FL 32503-2162

Phone

(850) 476-0977

Fax

(850) 476-2558

NPI assigned

Dec 2, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa Ann Weekley

Title

Office Manager

Phone

(850) 476-0977

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Creekside Psychiatric Center2 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.

• Creekside Psychiatric Center

  • Case Management Agency
  • Pensacola, FL
  • NPI 1730200023
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wendy Marling Depury, LCSW

  • Clinical Social Worker
  • Pensacola, FL
  • NPI 1275626152
  Medicare reassignment NPD

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1225330897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5190 BAYOU BLVD STE 6",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032162",
            "telephone_number": "850-476-0977",
            "fax_number": "850-476-2558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5190 BAYOU BLVD STE 6",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032162",
            "telephone_number": "850-476-0977",
            "fax_number": "850-476-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE PSYCHIATRIC CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "WEEKLEY",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-476-0977",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Alexander Crawford, PA
• David J Creahan Jr., RPH
• Jessica Creamer, DPT
• Mindy Kaye Credeur, PTA
• Creekside Psychiatric Center
• Creighton Chiropractic Center
• Cherry A. Creighton, AUD
• Elizabeth Anne Cremeans, MS, OTR/L
• Cherael Crenshaw, OTR
• Deja Crenshaw, LMT

• Mental Health Counselor in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.