NPIMap

Organization Active NPI

Creative Behavioral Connections Utah

  • Mental Health Counselor
  • Midvale, UT
National Provider Identifier
1861225575
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CREATIVE BEHAVIORAL CONNECTIONS UTAH
Practice address
1108 E South Union Ave
Midvale, UT 84047-2904
Phone
(702) 901-5200
NPI assigned
Aug 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
Abby Grossa
Title
Cfo
Phone
(702) 901-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1108 E South Union Ave
Midvale, UT 84047-2904

Mailing address

5803 W Craig Rd Ste 105
Las Vegas, NV 89130-2537

National Provider Directory

National Provider Directory
Tax ID family
Creative Behavioral Connections Utah3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1861225575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5803 W CRAIG RD STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891302537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 E SOUTH UNION AVE",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840472904",
            "telephone_number": "702-901-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE BEHAVIORAL CONNECTIONS UTAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "GROSSA",
        "authorized_official_first_name": "ABBY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "702-901-5200"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midvale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.