Creative Interactions

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

MULITPLE LICENSES Issued in NM

Legal business name

CREATIVE INTERACTIONS

Practice address

7200 Montgomery Blvd NE # 194
Albuquerque, NM 87109-1510

Phone

(505) 238-6106

NPI assigned

Jan 25, 2007

Organization subpart

No

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

Authorized official

Name

Jessica Penick, MS, CCC, SLPNPI 1548399967

Title

Vice President

Phone

(505) 238-6106

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica Penick, MS, CCC-SLP

  • Speech-Language Pathologist
  • Albuquerque, NM
  • NPI 1548399967
  NPD (past) Authorized official

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477609287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 MONTGOMERY BLVD NE # 194",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091510",
            "telephone_number": "505-238-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 MONTGOMERY BLVD NE # 194",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091510",
            "telephone_number": "505-238-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE INTERACTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PENICK",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "505-238-6106",
        "authorized_official_credential": "MS, CCC, SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "MULITPLE LICENSES",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "62725203",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Shalada Cristal Creecy-Gutierrez, LCSW
• Christopher Creel
• Clarice May Carles Cregger
• Victoria Crenshaw, CPSW

• Speech-Language Pathologist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Speech-Language Pathologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.