Provider Demographics
NPI:1285257386
Name:CREATIVE HEALING THERAPY SOLUTIONS
Entity type:Organization
Organization Name:CREATIVE HEALING THERAPY SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:IRISH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:951-529-2772
Mailing Address - Street 1:1400 QUAIL ST STE 275
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2762
Mailing Address - Country:US
Mailing Address - Phone:657-215-0465
Mailing Address - Fax:949-209-1980
Practice Address - Street 1:1400 QUAIL ST STE 275
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2762
Practice Address - Country:US
Practice Address - Phone:657-215-0465
Practice Address - Fax:949-209-1980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-22
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA100211512Medicaid