Northwest Creative Therapy LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

C4168 Issued in OR

Legal business name

NORTHWEST CREATIVE THERAPY LLC

Practice address

1744 NE 42ND Ave
Suite a
Portland, OR 97213-1537

Phone

(503) 333-5535

NPI assigned

Jun 28, 2016

Last updated

Jun 28, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leslie Ellen Jones, LPC, ATR-BCNPI 1790138485

Title

Principal Officer

Phone

(503) 333-5535

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Leslie Ellen Jones, LPC

  • Professional Counselor
  • Portland, OR
  • NPI 1790138485
  Authorized official Same address or phone

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467072000000",
    "number": "1427409697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1744 NE 42ND AVE",
            "address_2": "SUITE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131537",
            "telephone_number": "503-333-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 NE 42ND AVE",
            "address_2": "SUITE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131537",
            "telephone_number": "503-333-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST CREATIVE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-28",
        "last_updated": "2016-06-28",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "PRINCIPAL OFFICER",
        "authorized_official_telephone_number": "503-333-5535",
        "authorized_official_credential": "LPC, ATR-BC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OR",
            "license": "C4168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Portland, OR
• Providers in Portland, OR by specialty
• Community/Behavioral Health Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.