Active NPI
David J Creek, LMFT
- Marriage & Family Therapist
- Rockford, IL
National Provider Identifier
1578813119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 166.001308
- Practice address
- 6653 Weaver Rd
Rockford, IL 61114-8025 - Phone
- (815) 200-9636
- NPI assigned
- Sep 11, 2012
- Last updated
- Jun 1, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 166001308 | IL | |
| Marriage & Family Therapist | 106H00000X | 3239 | MN | |
| Marriage & Family Therapist | 106H00000X | 166.001308 | IL | Primary |
Addresses
Primary practice location
6653 Weaver Rd
Rockford, IL 61114-8025
Mailing address
6653 Weaver Rd
Rockford, IL 61114-8025
Phone (815) 200-9636
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 360450100M | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 166.001308 | IL | MD | Marriage & Family Therapist |
| 166001308 | IL | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creek Counseling | Current | Accepting new patients |
Locations
6653 Weaver Rd
Rockford, IL 61114
Phone (815) 200-9636
7294 Argus Dr
Rockford, IL 61107
Phone (815) 391-3055
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinic/Center
- Rockford, IL
- NPI 1639715923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590969600000",
"number": "1578813119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6653 WEAVER RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611148025",
"telephone_number": "815-200-9636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6653 WEAVER RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611148025",
"telephone_number": "815-200-9636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CREEK",
"first_name": "DAVID",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-09-11",
"last_updated": "2020-06-01",
"certification_date": "2020-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IL",
"license": "166001308",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "3239",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IL",
"license": "166.001308",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "360450100M",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.