Creative Wisdom Counseling Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CREATIVE WISDOM COUNSELING SERVICES, LLC

Practice address

2700 W Ardmore PL
West Peoria, IL 61604-4934

Phone

(309) 989-0052

NPI assigned

Nov 23, 2020

Organization subpart

No

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

Authorized official

Name

Karen L Watson, LCSWNPI 1104009224

Title

Mental Health Professional

Phone

(309) 989-0052

Specialties & licenses 1

Addresses

Other names 1

• Creative Wisdom Counseling Services, LLC Other name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

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

• Karen Lynn Watson, LCSW

  • Clinical Social Worker
  • West Peoria, IL
  • NPI 1104009224
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1851995641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 W ARDMORE PL",
            "city": "WEST PEORIA",
            "state": "IL",
            "postal_code": "616044934",
            "telephone_number": "309-989-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W ARDMORE PL",
            "city": "WEST PEORIA",
            "state": "IL",
            "postal_code": "616044934",
            "telephone_number": "309-989-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE WISDOM COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-23",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MENTAL HEALTH PROFESSIONAL",
        "authorized_official_telephone_number": "309-989-0052",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creative Wisdom Counseling Services, LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Creative Wisdom Counseling Services, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Catholic Charities of the Diocese of Peoria
• Catholic Charities of the Diocese of Peoria
• Brianna M Coleman, PMHNP
• County of Peoria
• County of Peoria
• Andrea Desatnick, MA, NCC, LCPC
• Easter Seals-Ucp
• Chad Endres
• Keith R Fuentes, PHARM.D.
• Galva Family Dentistry, Inc

• Clinical Social Worker in West Peoria, IL
• Providers in West Peoria, IL by specialty
• Clinical Social Worker in Illinois

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