Organization Active NPI

Creative Intelligence Services PLLC

  • Mental Health Counselor
  • Wilmington, NC
National Provider Identifier
1689178477
Registry record updated Mar 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CREATIVE INTELLIGENCE SERVICES PLLC
Practice address
125 S 4TH St
Wilmington, NC 28401-4508
Phone
(336) 389-1413
NPI assigned
Mar 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2018

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

Authorized official

Name
David James Bolton
Title
Ceo
Phone
(336) 389-1413

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

125 S 4TH St
Wilmington, NC 28401-4508

Mailing address

125 S 4TH St
Wilmington, NC 28401-4508

National Provider Directory

National Provider Directory

Locations

201 N Front St
Wilmington, NC 28401
Phone (910) 795-9735

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": "1521417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521417600000",
    "number": "1689178477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S 4TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284014508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S 4TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284014508",
            "telephone_number": "336-389-1413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE INTELLIGENCE SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-19",
        "last_updated": "2018-03-19",
        "status": "A",
        "authorized_official_last_name": "BOLTON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-389-1413"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; 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.