Create Space Wellness Services

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CREATE SPACE WELLNESS SERVICES

Practice address

330 Main St FL 2
Hartford, CT 06106-1851

Phone

(860) 869-2021

NPI assigned

Oct 31, 2023

Organization subpart

No

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

Authorized official

Name

Tabia L Thornton-Bey, LCSWNPI 1073918660

Title

Ceo/ Founder

Phone

(860) 869-2021

Specialties & licenses 1

Addresses

Practitioners 1

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

• Tabia Thornton-Bey

  • Clinical Social Worker
  • Plainville, CT
  • NPI 1073918660
  NPD Authorized official

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1598538795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 HARTZ LN",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061181718",
            "telephone_number": "860-869-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MAIN ST FL 2",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061061851",
            "telephone_number": "860-869-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATE SPACE WELLNESS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "THORNTON-BEY",
        "authorized_official_first_name": "TABIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO/ FOUNDER",
        "authorized_official_telephone_number": "860-869-2021",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Hartford, CT
• Providers in Hartford, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.