CENTER FOR CREATIVE CHANGE NPI 1619201746

NPI Information

NPI: 1619201746
Provider Name: CENTER FOR CREATIVE CHANGE
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
506 NORTH ST
FARMINGTON, MO
ZIP 63640
Phone: (573) 756-3330
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CENTER FOR CREATIVE CHANGE is a mental health counselor in Farmington, MO. CENTER FOR CREATIVE CHANGE NPI is 1619201746. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

506 NORTH ST
FARMINGTON, MO
ZIP 63640-213
Phone: (573) 756-3330
Fax: (573) 747-3023

The provider's authorized official is Lynn S James .
The authorized official title is Counselor/owner and has the following contact phone number (573) 756-3330.

The enumeration date for this NPI number is 9/22/2009 and was last updated on 9/22/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	001502	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	493642904	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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