Organization Active NPI

Creative Counseling Associates, LLC

  • Mental Health Counselor
  • Bartlett, IL
National Provider Identifier
1285836437
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180005808 Issued in IL
Legal business name
CREATIVE COUNSELING ASSOCIATES, LLC
Practice address
848 W Bartlett Rd
Suite 12E
Bartlett, IL 60103-4493
Phone
(630) 837-5303
Fax
(630) 837-5305
NPI assigned
Jun 1, 2007
Last updated
Dec 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Authorized official

Name
Mrs. Corinna Marie Costello, LCPC, ATR-BCNPI 1164431136
Title
Director, Counselor
Phone
(630) 837-5303

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 96178 IL
Mental Health Counselor 101YM0800X 180005808 IL Primary
Professional Counselor 101YP2500X 180005808 IL

Addresses

Primary practice location

848 W Bartlett Rd
Suite 12E
Bartlett, IL 60103-4493

Mailing address

848 W Bartlett Rd
Suite 12E
Bartlett, IL 60103-4493
Phone (630) 837-5303

National Provider Directory

National Provider Directory

Locations

848 W Bartlett Rd
Ste 12E
Bartlett, IL 60103
Phone (630) 837-5303

Practitioners & affiliated clinicians

Practitioners 2

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": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1285836437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "848 W BARTLETT RD",
            "address_2": "SUITE 12E",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601034493",
            "telephone_number": "630-837-5303",
            "fax_number": "630-837-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 W BARTLETT RD",
            "address_2": "SUITE 12E",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601034493",
            "telephone_number": "630-837-5303",
            "fax_number": "630-837-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE COUNSELING ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "CORINNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR, COUNSELOR",
        "authorized_official_telephone_number": "630-837-5303",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC, ATR-BC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "96178",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180005808",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180005808",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.