NPIMap

Organization Active NPI

Creative Counseling Center

  • Professional Counselor
  • Winston Salem, NC
National Provider Identifier
1407222706
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8040 Issued in NC
Legal business name
CREATIVE COUNSELING CENTER
Practice address
163 Stratford CT
Suite #170
Winston Salem, NC 27103-1836
Phone
(336) 448-4123
Fax
(336) 436-9123
NPI assigned
Aug 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Authorized official

Name
Mrs. Sonya Renee Oglesby, LPC, NCC, LCAS-A
Title
Ceo
Phone
(336) 830-4765

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 3028-A NC
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 8040 NC
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 8040 NC Primary

Addresses

Primary practice location

163 Stratford CT
Suite #170
Winston Salem, NC 27103-1836

Mailing address

163 Stratford CT
Suite #170
Winston Salem, NC 27103-1836
Phone (336) 448-4123

Other identifiers 1

IdentifierTypeStateIssuer
6115116MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1407222706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 STRATFORD CT",
            "address_2": "SUITE #170",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031836",
            "telephone_number": "336-448-4123",
            "fax_number": "336-436-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 STRATFORD CT",
            "address_2": "SUITE #170",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031836",
            "telephone_number": "336-448-4123",
            "fax_number": "336-436-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "OGLESBY",
        "authorized_official_first_name": "SONYA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-830-4765",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC, NCC, LCAS-A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "3028-A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "8040",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "8040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6115116",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.