NPIMap

Organization Active NPI

Creative Healing Expressive Arts Center

  • Adult Mental Health Clinic/Center
  • Bloomington, IL
National Provider Identifier
1275305278
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
CREATIVE HEALING EXPRESSIVE ARTS CENTER
Practice address
107 E Chestnut St
Bloomington, IL 61701-3009
Phone
(309) 490-3060
Fax
(309) 490-3060
NPI assigned
Oct 24, 2023
Last updated
Jan 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Authorized official

Name
Karli JohnsonNPI 1023525292
Title
Founder
Phone
(309) 287-0610

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

107 E Chestnut St
Bloomington, IL 61701-3009

Mailing address

200 W Monroe St Ste 23
Bloomington, IL 61701-3955
Phone (309) 287-0610

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1275305278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W MONROE ST STE 23",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013955",
            "telephone_number": "309-287-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E CHESTNUT ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013009",
            "telephone_number": "309-490-3060",
            "fax_number": "309-490-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE HEALING EXPRESSIVE ARTS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-24",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KARLI",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "309-287-0610"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.