Createwellness, Licensed Clinical Social Worker Corporation

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CREATEWELLNESS, LICENSED CLINICAL SOCIAL WORKER CORPORATION

Practice address

5250 Hayter Avenue
Lakewood, CA 90712

Phone

(805) 870-5709

NPI assigned

Sep 14, 2020

Organization subpart

No

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

Authorized official

Name

Kalkidan Zeryihun

Title

Clinical Director

Phone

(805) 870-5709

Specialties & licenses 1

Addresses

Other names 1

• CreateWellness Doing business as

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1689289944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10303 DORCHESTER ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933114921",
            "telephone_number": "805-870-5709",
            "fax_number": "844-907-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 HAYTER AVENUE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "90712",
            "telephone_number": "805-870-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATEWELLNESS, LICENSED CLINICAL SOCIAL WORKER CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-14",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "ZERYIHUN",
        "authorized_official_first_name": "KALKIDAN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "805-870-5709"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CreateWellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• County of Los Angeles
• Conrad A. Cox, M.D.
• Gerald A. Cox II, MD, MPH
• Craig B. Scheffel, O.D., Inc.
• Teresa Marie Cramer, PT
• Amanda Crihfield
• Crittenton Services for Children and Families
• Adria Cromosini, MS, OTR/L
• Carleigh Cruz
• Maddelyn Cruz

• Clinical Social Worker in Lakewood, CA
• Providers in Lakewood, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.