Organization Active NPI

Creative Psychotherapy, PC

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1396049482
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C006227 Issued in NC
Legal business name
CREATIVE PSYCHOTHERAPY, PC
Practice address
185 Wind Chime CT
#104
Raleigh, NC 27615-6481
Phone
(919) 848-9715
Fax
(919) 848-9716
NPI assigned
Jan 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Authorized official

Name
Ms. Marybeth Auld, MSW,LCSW,NBCCH
Title
Owner/Clinician
Phone
(919) 848-9715

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X C006227 NC Primary

Addresses

Primary practice location

185 Wind Chime CT
#104
Raleigh, NC 27615-6481

Mailing address

185 Wind Chime CT
#104
Raleigh, NC 27615-6481
Phone (919) 848-9715

National Provider Directory

National Provider Directory

Locations

185 Wind Chime Ct
Ste 104
Raleigh, NC 27615
Phone (919) 624-5100

NPI Registry JSON

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403049600000",
    "number": "1396049482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 WIND CHIME CT",
            "address_2": "#104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156481",
            "telephone_number": "919-848-9715",
            "fax_number": "919-848-9716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 WIND CHIME CT",
            "address_2": "#104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156481",
            "telephone_number": "919-848-9715",
            "fax_number": "919-848-9716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE PSYCHOTHERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2014-06-18",
        "status": "A",
        "authorized_official_last_name": "AULD",
        "authorized_official_first_name": "MARYBETH",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "919-848-9715",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW,LCSW,NBCCH"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; 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.