NPIMap

Organization Active NPI

Creative Potential LLC

  • Professional Counselor
  • Uncasville, CT
National Provider Identifier
1497121933
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
CREATIVE POTENTIAL LLC
Practice address
1031 Norwich New London Tpke Unit 10
Uncasville, CT 06382-1600
Phone
(860) 848-0514
Fax
(860) 848-0523
NPI assigned
Aug 19, 2015
Last updated
Feb 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Authorized official

Name
Sierra R Davis
Title
Owner
Phone
(860) 848-0514

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

1031 Norwich New London Tpke Unit 10
Uncasville, CT 06382-1600

Mailing address

1031 Norwich New London Tpke Unit 10
Uncasville, CT 06382-1600
Phone (860) 848-0514

Other practice location 1

154 Hempstead St Fl 1
New London, CT 06320-5638
Phone (860) 961-7238

National Provider Directory

National Provider Directory
Tax ID family
Creative Potential5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582243200000",
    "number": "1497121933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 NORWICH NEW LONDON TPKE UNIT 10",
            "city": "UNCASVILLE",
            "state": "CT",
            "postal_code": "063821600",
            "telephone_number": "860-848-0514",
            "fax_number": "860-848-0523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 NORWICH NEW LONDON TPKE UNIT 10",
            "city": "UNCASVILLE",
            "state": "CT",
            "postal_code": "063821600",
            "telephone_number": "860-848-0514",
            "fax_number": "860-848-0523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "154 Hempstead St Fl 1",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "CT",
            "postal_code": "063205638",
            "country_code": "US",
            "telephone_number": "860-961-7238",
            "fax_number": "860-437-0518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CREATIVE POTENTIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-19",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SIERRA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-848-0514"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Uncasville, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.