Provider Demographics
NPI:1972317931
Name:CREATIVE GROWTH THERAPY SERVICES, LLC
Entity type:Organization
Organization Name:CREATIVE GROWTH THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:MCMASTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, SLP-CCC
Authorized Official - Phone:530-414-5675
Mailing Address - Street 1:10 MECHANIC ST APT B
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-2726
Mailing Address - Country:US
Mailing Address - Phone:530-414-5675
Mailing Address - Fax:
Practice Address - Street 1:10 MECHANIC ST APT B
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-2726
Practice Address - Country:US
Practice Address - Phone:530-414-5675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-01
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty