Provider Demographics
NPI:1699310433
Name:CREATIVE THERAPIES, PLLC
Entity type:Organization
Organization Name:CREATIVE THERAPIES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR AND THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAINE
Authorized Official - Suffix:
Authorized Official - Credentials:LCAS, LPCA
Authorized Official - Phone:919-880-4078
Mailing Address - Street 1:6103 KAYTON ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-4329
Mailing Address - Country:US
Mailing Address - Phone:919-880-4078
Mailing Address - Fax:
Practice Address - Street 1:6103 KAYTON ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-4329
Practice Address - Country:US
Practice Address - Phone:919-880-4078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-15
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty