Creative Counseling Services, L.L.C.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2004024505 Issued in MO

Legal business name

CREATIVE COUNSELING SERVICES, L.L.C.

Practice address

173 Lisa Ave
Poplar Bluff, MO 63901-9093

Phone

(573) 714-4076

Fax

(573) 785-6813

NPI assigned

Jul 9, 2006

Organization subpart

No

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

Authorized official

Name

Timothy Paul Pennington, LCSW

Title

Licensed Clinical Social Worker

Phone

(573) 714-4076

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881627156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 LISA AVE",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639019093",
            "telephone_number": "573-714-4076",
            "fax_number": "573-785-6813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 LISA AVE",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639019093",
            "telephone_number": "573-714-4076",
            "fax_number": "573-785-6813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE COUNSELING SERVICES, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PENNINGTON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "573-714-4076",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2004024505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Gayle Cravens-Purl, LMSW
• April Louise Elane Crawford
• Zachary Ryan Crawford
• Richard Leroy Crayton
• Matt Creason
• Andrea Crismon, PHARMD
• Rebecca Crites
• Vivian Jean Crites, RN, FNP-BC
• Andrea Cross, PT
• Richard Scott Crouse, FNP

• Clinical Social Worker in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.