Active NPI
Creative Psychotherapy, PC
- Clinical Social Worker
- Raleigh, NC
National Provider Identifier
1396049482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C006227
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 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 DirectoryLocations
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.