Organization Active NPI

Creative Roots Counseling

  • Mental Health Counselor
  • Theresa, WI
National Provider Identifier
1740166495
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CREATIVE ROOTS COUNSELING
Practice address
N9450 Mohawk Rd Ste 113
Theresa, WI 53091-9770
Phone
(920) 948-3706
NPI assigned
Aug 15, 2025
Last updated
Aug 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Authorized official

Name
Amber Brown, MS, LPC, ATRNPI 1861266082
Title
Owner, Mental Health Therapist
Phone
(920) 948-3706

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

N9450 Mohawk Rd Ste 113
Theresa, WI 53091-9770

Mailing address

W5175 County Road Y
Fond Du Lac, WI 54937-7783

National Provider Directory

National Provider Directory

Locations

N9450 Mohawk Rd
Ste 113
Theresa, WI 53091
Phone (920) 948-3706

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1755216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1740166495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W5175 COUNTY ROAD Y",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549377783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N9450 MOHAWK RD STE 113",
            "city": "THERESA",
            "state": "WI",
            "postal_code": "530919770",
            "telephone_number": "920-948-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE ROOTS COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "OWNER, MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "920-948-3706",
        "authorized_official_credential": "MS, LPC, ATR"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Theresa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; 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.