NPIMap

Organization Active NPI

Creative Spirit Counseling

  • Professional Counselor
  • Eugene, OR
National Provider Identifier
1902309677
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C3044 Issued in OR
Legal business name
CREATIVE SPIRIT COUNSELING
Practice address
739 W 5TH Ave
Eugene, OR 97402-5103
Phone
(541) 514-7997
NPI assigned
Mar 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Authorized official

Name
Rachelle Cornelius, LPCNPI 1861636904
Title
Owner & Provider
Phone
(541) 514-7997

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
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X C3044 OR Primary

Addresses

Primary practice location

739 W 5TH Ave
Eugene, OR 97402-5103

Mailing address

739 W 5TH Ave
Eugene, OR 97402-5103

Other identifiers 1

IdentifierTypeStateIssuer
500732306MedicaidOR

Other names 1

  • Creative Spirit Collaborative Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Info@creativespiritcollaborative.com

National Provider Directory

National Provider Directory

Locations

739 W 5th Ave
Eugene, OR 97402
Phone (541) 514-7997

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627862400000",
    "number": "1902309677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 W 5TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974025103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 W 5TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974025103",
            "telephone_number": "541-514-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE SPIRIT COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-08",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A",
        "authorized_official_last_name": "CORNELIUS",
        "authorized_official_first_name": "RACHELLE",
        "authorized_official_title_or_position": "OWNER & PROVIDER",
        "authorized_official_telephone_number": "541-514-7997",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500732306",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Info@creativespiritcollaborative.com",
            "affiliation": "N",
            "address_1": "739 W 5th Ave",
            "city": "Eugene",
            "state": "OR",
            "country_code": "US",
            "postal_code": "974025103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Creative Spirit Collaborative",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.