Provider Demographics
NPI:1962172049
Name:CREATIVE TRANSFORMATIONS LLC
Entity type:Organization
Organization Name:CREATIVE TRANSFORMATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:724-699-9056
Mailing Address - Street 1:60 STRAWBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-3234
Mailing Address - Country:US
Mailing Address - Phone:172-469-9905
Mailing Address - Fax:724-558-9559
Practice Address - Street 1:60 STRAWBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-3234
Practice Address - Country:US
Practice Address - Phone:172-469-9905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty