NPIMap

Organization Active NPI

Creative Therapy PLLC

  • Community/Behavioral Health Agency
  • Valley City, ND
National Provider Identifier
1508234295
Registry record updated Sep 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CREATIVE THERAPY PLLC
Practice address
150 2ND St SW
#1
Valley City, ND 58072-3302
Phone
(701) 490-3281
Fax
(701) 490-3283
NPI assigned
Sep 11, 2015
Last updated
Sep 11, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2015

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

Authorized official

Name
Jennifer L Eberle, LPCNPI 1184903544
Title
President/ Mental Health Counselor
Phone
(701) 490-3281

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X ND Primary

Addresses

Primary practice location

150 2ND St SW
#1
Valley City, ND 58072-3302

Mailing address

150 2ND St SW
#1
Valley City, ND 58072-3302
Phone (701) 490-3281

Other identifiers 1

IdentifierTypeStateIssuer
56667MedicaidND

Other names 1

  • Creative Therapy Addiction Program Other name

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.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441929600000",
    "number": "1508234295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 2ND ST SW",
            "address_2": "#1",
            "city": "VALLEY CITY",
            "state": "ND",
            "postal_code": "580723302",
            "telephone_number": "701-490-3281",
            "fax_number": "701-490-3283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 2ND ST SW",
            "address_2": "#1",
            "city": "VALLEY CITY",
            "state": "ND",
            "postal_code": "580723302",
            "telephone_number": "701-490-3281",
            "fax_number": "701-490-3283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-11",
        "last_updated": "2015-09-11",
        "status": "A",
        "authorized_official_last_name": "EBERLE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT/ MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "701-490-3281",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ND",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56667",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creative Therapy Addiction Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Sep 11, 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.