Creative ABA, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

CREATIVE ABA, LLC

Practice address

3720 Glenview Cir
Modesto, CA 95355-1309

Phone

(209) 408-9922

NPI assigned

Feb 23, 2022

Organization subpart

No

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

Authorized official

Name

Alexis Rose Winters, BCBA

Title

Clinical Director

Phone

(209) 408-9992

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1619623154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 GLENVIEW CIR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551309",
            "telephone_number": "209-408-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 GLENVIEW CIR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551309",
            "telephone_number": "209-408-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE ABA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-23",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "WINTERS",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "209-408-9992",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin L Craig, MD
• Mackenzie Cathryn Craigg
• Renee Cynthia-Lauderdale Crawford, MSW
• Shannise S Crawford
• Diane Crayton, FNP
• Credence Family Counseling
• Nancy Lou Creech, M.S.
• Paul Samuel Crenshaw, LCSW
• Crescent Post Acute Consultants Inc
• Crescent Wound Care Inc

• Behavior Analyst in Modesto, CA
• Providers in Modesto, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.