Provider Demographics
NPI:1962552455
Name:CREIGHTON, JAMES SCOTT (PSYD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SCOTT
Last Name:CREIGHTON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 HELENA ST APT 206
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-1571
Mailing Address - Country:US
Mailing Address - Phone:617-642-3015
Mailing Address - Fax:
Practice Address - Street 1:508 DEEP EDDY AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-4555
Practice Address - Country:US
Practice Address - Phone:512-469-0889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2023-07-24
Deactivation Date:2012-02-29
Deactivation Code:
Reactivation Date:2019-06-06
Provider Licenses
StateLicense IDTaxonomies
TX38084103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical