NPIMap

Organization Active NPI

Creative Therapy

  • Community/Behavioral Health Agency
  • Valley City, ND
National Provider Identifier
1417364977
Registry record updated Nov 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
694-8-1-11 Issued in ND
Legal business name
CREATIVE THERAPY
Practice address
323 Central Ave N
Suite 203
Valley City, ND 58072-2915
Phone
(701) 367-8293
NPI assigned
Jul 16, 2014
Last updated
Nov 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2015

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

Authorized official

Name
Jennifer Lynn Eberle, LPC, NCCNPI 1184903544
Title
Counselor
Phone
(701) 367-8293

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 694-8-1-11 ND Primary

Addresses

Primary practice location

323 Central Ave N
Suite 203
Valley City, ND 58072-2915

Mailing address

323 Central Ave N
Suite 203
Valley City, ND 58072-2915
Phone (701) 367-8293

Other identifiers 2

IdentifierTypeStateIssuer
1455895MedicaidND
1462435MedicaidND

National Provider Directory

National Provider Directory
Tax ID family
Creative Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

323 Central Ave N
Ste 203
Valley City, ND 58072
Phone (701) 490-3281

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447027200000",
    "number": "1417364977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 CENTRAL AVE N",
            "address_2": "SUITE 203",
            "city": "VALLEY CITY",
            "state": "ND",
            "postal_code": "580722915",
            "telephone_number": "701-367-8293",
            "fax_number": "701-490-3283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 CENTRAL AVE N",
            "address_2": "SUITE 203",
            "city": "VALLEY CITY",
            "state": "ND",
            "postal_code": "580722915",
            "telephone_number": "701-367-8293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-16",
        "last_updated": "2015-11-09",
        "status": "A",
        "authorized_official_last_name": "EBERLE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "701-367-8293",
        "authorized_official_credential": "LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ND",
            "license": "694-8-1-11",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1455895",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1462435",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley City, ND

Sources for this page

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