Creative Space Online Counseling and Coaching, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

CREATIVE SPACE ONLINE COUNSELING AND COACHING, LLC

Practice address

1566 Skyridge Dr Unit 2
Crystal Lake, IL 60014-1027

Phone

(224) 623-2251

NPI assigned

Feb 19, 2019

Organization subpart

No

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

Authorized official

Name

Barbara Maulding, LCPCNPI 1710352422

Title

Ceo/Therapist

Phone

(224) 623-2251

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Creative Space Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Barbara Maulding, LCPC

  • Professional Counselor
  • Crystal Lake, IL
  • NPI 1710352422

  Mental Health

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1720544463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1566 SKYRIDGE DR UNIT 2",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600141027",
            "telephone_number": "224-623-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1566 SKYRIDGE DR UNIT 2",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600141027",
            "telephone_number": "224-623-2251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Burdent Dr Ste F",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600144233",
            "country_code": "US",
            "telephone_number": "224-623-2251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CREATIVE SPACE ONLINE COUNSELING AND COACHING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-19",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "MAULDING",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "CEO/THERAPIST",
        "authorized_official_telephone_number": "224-623-2251",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218215315001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDFPR",
            "identifier": "180010906",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creative Space",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Creative Space",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Ann Crane, D.C.
• Megan Crane
• Jessica Crawford
• Creative Psychological Solutions LLC
• Creative Psychology, LTD.
• Daisy Creatore, PMHNP-BC
• Cronin Medical Group, LTD.
• Margaret Crowley
• Crystal Family Dental Care
• Crystal Lake CC SCH Dist 47

• Professional Counselor in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.