Organization Active NPI

Creative Psychological Solutions LLC

  • Psychologist
  • Crystal Lake, IL
National Provider Identifier
1679719652
Registry record updated Aug 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071-006447 Issued in IL
Legal business name
CREATIVE PSYCHOLOGICAL SOLUTIONS LLC
Practice address
350 E Congress Pkwy
Suite L
Crystal Lake, IL 60014-6284
Phone
(815) 355-4292
Fax
(815) 356-7139
NPI assigned
Dec 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2011

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

Authorized official

Name
Catherine Dean, PSY.D.NPI 1356340616
Title
Sole Member
Phone
(815) 355-4292

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 071-006447 IL Primary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 3-1970 TX

Addresses

Primary practice location

350 E Congress Pkwy
Suite L
Crystal Lake, IL 60014-6284

Mailing address

104 W Meadow Dr
Cortland, IL 60112-4226
Phone (815) 355-4292

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1229990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314057600000",
    "number": "1679719652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W MEADOW DR",
            "city": "CORTLAND",
            "state": "IL",
            "postal_code": "601124226",
            "telephone_number": "815-355-4292",
            "fax_number": "815-356-7139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E CONGRESS PKWY",
            "address_2": "SUITE L",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146284",
            "telephone_number": "815-355-4292",
            "fax_number": "815-356-7139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE PSYCHOLOGICAL SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-23",
        "last_updated": "2011-08-23",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "815-355-4292",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071-006447",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "3-1970",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; 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.