The Creative Therapy Center, LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

THE CREATIVE THERAPY CENTER, LLC

Practice address

815 Highway 10 Ste 102
Elk River, MN 55330-5204

Phone

(763) 274-0510

NPI assigned

Jun 10, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Nicole Renee-Hauser Baker, PHD, LMFT, RPTNPI 1326486879

Title

Clinic Director

Phone

(763) 274-0510

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 5

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

• Nicole Renee-Hauser Baker, PHD, LMFT

  • Marriage & Family Therapist
  • Elk River, MN
  • NPI 1326486879
  Medicare reassignment NPD Authorized official
• Amanda Hunter, LICSW

  • Clinical Social Worker
  • Elk River, MN
  • NPI 1407610579
  NPD
• Tasha Burg, MA

  • Professional Counselor
  • Elk River, MN
  • NPI 1598696742
  NPD (past)
• Cortney Foster, LICSW

  • Clinical Social Worker
  • Elk River, MN
  • NPI 1275215329
  NPD (past)
• Abigail Rae Wagner, LPC, LADC

  • Mental Health Counselor
  • Elk River, MN
  • NPI 1033603527
  NPD (past)

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1609196898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 MAIN ST NW STE 214",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301584",
            "telephone_number": "763-274-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 HIGHWAY 10 STE 102",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553305204",
            "telephone_number": "763-274-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CREATIVE THERAPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-10",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "RENEE-HAUSER",
        "authorized_official_title_or_position": "CLINIC  DIRECTOR",
        "authorized_official_telephone_number": "763-274-0510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LMFT, RPT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabitha Carlie Szulga
• Jocelyn Savai Talso
• Emma Ann Teal
• Leah Temple
• Cassandra Marie Terch
• Garrett Connor Theiringer
• Kate Theisz, PSY.D.
• Sujaya Thogaru
• Darin William Thom, PT
• Erick Thompson, DC

• Marriage & Family Therapist in Elk River, MN
• Providers in Elk River, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.