Provider Demographics
NPI:1992026405
Name:CREATIVE THERAPY SERVICES
Entity type:Organization
Organization Name:CREATIVE THERAPY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ROBIN
Authorized Official - Last Name:CARLAMERE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:856-232-4770
Mailing Address - Street 1:1546 BLACKWOOD CLEMENTON RD
Mailing Address - Street 2:PO BOX 173
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-4626
Mailing Address - Country:US
Mailing Address - Phone:856-232-4770
Mailing Address - Fax:
Practice Address - Street 1:1546 BLACKWOOD CLEMENTON RD
Practice Address - Street 2:
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-4626
Practice Address - Country:US
Practice Address - Phone:856-232-4770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05231881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty