NPIMap

Organization Active NPI

Creative Counseling Center of Nwa, PLLC

  • Professional Counselor
  • Bentonville, AR
National Provider Identifier
1346890027
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
CREATIVE COUNSELING CENTER OF NWA, PLLC
Practice address
902 McClain Rd Ste 6003
Bentonville, AR 72712-6379
Phone
(479) 257-1919
NPI assigned
Sep 16, 2019
Last updated
Sep 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Authorized official

Name
Charlotte Evans, LPC
Title
Co Owner
Phone
(479) 257-1919

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary
Clinical Social Worker 1041C0700X NU

Addresses

Primary practice location

902 McClain Rd Ste 6003
Bentonville, AR 72712-6379

Mailing address

902 McClain Rd Ste 6003
Bentonville, AR 72712-6379

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL creativenwa.com

National Provider Directory

National Provider Directory

Locations

902 McClain Rd
Ste 6003
Bentonville, AR 72712
Phone (479) 257-1919

Practitioners & affiliated clinicians

Practitioners 11

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": "1568592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568592000000",
    "number": "1346890027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 MCCLAIN RD STE 6003",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727126379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 MCCLAIN RD STE 6003",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727126379",
            "telephone_number": "479-257-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE COUNSELING CENTER OF NWA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-16",
        "last_updated": "2019-09-16",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "479-257-1919",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "creativenwa.com",
            "affiliation": "N",
            "address_1": "902 McClain Rd Ste 6003",
            "city": "Bentonville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727126379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.