Creative Psychology Center Inc.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801012479 Issued in MI

Legal business name

CREATIVE PSYCHOLOGY CENTER INC.

Practice address

20816 E 11 Mile Rd
Suite #113
Saint Clair Shores, MI 48081-1565

Phone

(586) 447-0130

NPI assigned

Mar 5, 2008

Last updated

Mar 5, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Keith D Russell, PHD, LMSW

Title

President

Phone

(586) 447-0130

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1639349657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20816 E 11 MILE RD",
            "address_2": "SUITE #113",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811565",
            "telephone_number": "586-447-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20816 E 11 MILE RD",
            "address_2": "SUITE #113",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811565",
            "telephone_number": "586-447-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE PSYCHOLOGY CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-447-0130",
        "authorized_official_credential": "PHD, LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801012479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Courtney
• Erica Couvreur
• Eric Lansdon Cowart
• Kathryn Elyse Cox, MD
• Linda L Crandall, MD
• Alexandra Cretu
• Richard John Cross, MD
• Kelly Crossley, DDS
• Jeffrey Cruz
• Lachelle Marie Cucinella, RN

• Clinical Social Worker in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.