NPIMap

Organization Active NPI

Creative Healing Mental Health Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chippewa Falls, WI
National Provider Identifier
1346960366
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CREATIVE HEALING MENTAL HEALTH CENTER LLC
Practice address
1791 County Highway Oo
Chippewa Falls, WI 54729-5347
Phone
(715) 829-0602
NPI assigned
Aug 30, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Authorized official

Name
Jenifer Olson, LCSWNPI 1386287522
Title
Owner
Phone
(715) 829-0602

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1791 County Highway Oo
Chippewa Falls, WI 54729-5347

Mailing address

1791 County Highway Oo
Chippewa Falls, WI 54729-5347
Phone (715) 797-2770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221212001959 WI Part B Supplier - Clinic/Group Practice 4688043748 Receives reassigned benefits from 11 practitioners
Practice locations: Chippewa Falls, WI

National Provider Directory

National Provider Directory

Locations

1791 County Highway OO
Chippewa Falls, WI 54729
Phone (715) 797-2770

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1346960366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1791 COUNTY HIGHWAY OO",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547295347",
            "telephone_number": "715-797-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1791 COUNTY HIGHWAY OO",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547295347",
            "telephone_number": "715-829-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE HEALING MENTAL HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-30",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "JENIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-829-0602",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chippewa Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.