NPIMap

Organization Active NPI

Creative Journey, LLC

  • Community/Behavioral Health Agency
  • Jamestown, ND
National Provider Identifier
1831607910
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CREATIVE JOURNEY, LLC
Practice address
429 2ND St SW Ste 205
Jamestown, ND 58401
Phone
(701) 658-9032
NPI assigned
Jan 11, 2018
Last updated
Jan 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Authorized official

Name
Ms. Shaulee Ahlers Iverson, MS OTR/LNPI 1184013377
Title
Coo/Administrator
Phone
(701) 658-9032

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
Community/Behavioral Health Agency 251S00000X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

429 2ND St SW Ste 205
Jamestown, ND 58401

Mailing address

419 5TH St NE # 14B
Jamestown, ND 58401-3318
Phone (701) 658-9032

Other names 1

  • Journey Behavioral Solutions, LLC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Creative Journey LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

429 2nd St SW
Ste 205
Jamestown, ND 58401
Phone (701) 658-9032

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": "1515628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611792000000",
    "number": "1831607910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 5TH ST NE # 14B",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013318",
            "telephone_number": "701-658-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 2ND ST SW STE 205",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "58401",
            "telephone_number": "701-658-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE JOURNEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-11",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A",
        "authorized_official_last_name": "IVERSON",
        "authorized_official_first_name": "SHAULEE",
        "authorized_official_middle_name": "AHLERS",
        "authorized_official_title_or_position": "COO/ADMINISTRATOR",
        "authorized_official_telephone_number": "701-658-9032",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS OTR/L"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Journey Behavioral Solutions, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Jamestown, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.