Creative Wellness, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

2000165042 Issued in MO

Legal business name

CREATIVE WELLNESS, LLC

Practice address

2558 S Brentwood Blvd
Saint Louis, MO 63144-2309

Phone

(314) 961-8940

Fax

(314) 961-8969

NPI assigned

Mar 21, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Brian Harasha, DC

Title

Owner

Phone

(314) 961-8940

Specialties & licenses 1

Addresses

Other names 1

• Advanced Laser Therapy and Wellness Doing business as

Locations

Practitioners 2

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

• Jana Leigh Gibson, D.C.

  • Chiropractor
  • University City, MO
  • NPI 1114327079
  NPD (past)
• Hongbo Lily Liu, O.M.D, PH.D.

  • Acupuncturist
  • Saint Louis, MO
  • NPI 1750729901
  NPD (past)

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591228800000",
    "number": "1609307776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2558 S BRENTWOOD BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631442309",
            "telephone_number": "314-961-8940",
            "fax_number": "143-961-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2558 S BRENTWOOD BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631442309",
            "telephone_number": "314-961-8940",
            "fax_number": "314-961-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-21",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A",
        "authorized_official_last_name": "HARASHA",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-961-8940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MO",
            "license": "2000165042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Laser Therapy and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cheryl Diane Crayton, LCSW
• Matthew Aaron Creacy, LPC
• Creath Counseling
• Creative Counseling 4 Kids LLC
• Creative Pathways to Wholeness, LLC
• Rachel Nicole Crebessa, MD
• Charles A Crecelius, MD
• Curt R Crecelius, CRNA
• Krystal Lynn Crecelius, NP
• Chelsi A Creech, PSYD

• Clinic/Center in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.