NPIMap

Organization Active NPI

Creative Counseling Group, LLC

  • Community/Behavioral Health Agency
  • Orlando, FL
National Provider Identifier
1386178838
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
IMH14125 Issued in FL
Legal business name
CREATIVE COUNSELING GROUP, LLC
Practice address
1928 Proctor Ave
Orlando, FL 32817-4200
Phone
(407) 810-8319
NPI assigned
Apr 11, 2017
Last updated
Apr 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Authorized official

Name
Mr. Tyler Allen Conner, MA, RMHCI
Title
Owner
Phone
(407) 810-8319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X IMH14125 FL Primary

Addresses

Primary practice location

1928 Proctor Ave
Orlando, FL 32817-4200

Mailing address

1928 Proctor Ave
Orlando, FL 32817-4200
Phone (407) 810-8319

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1386178838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1928 PROCTOR AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328174200",
            "telephone_number": "407-810-8319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1928 PROCTOR AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328174200",
            "telephone_number": "407-810-8319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE COUNSELING GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-11",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "CONNER",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-810-8319",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, RMHCI"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "IMH14125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.