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NPI Code Detail

MEDICARE: CREATIVE INTERVENTIONS COUNSELING, INC

MEDICARE: CREATIVE INTERVENTIONS COUNSELING, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist20042274AIN

General Provider Information

NPI Number : 1275840886
Entity Type Code : Organization
Provider Name (Legal Business Name) : CREATIVE INTERVENTIONS COUNSELING, INC
Provider Business Mailing Address
First Line : 8 MORGAN BLVD
Second Line :
City : VALPARAISO
State : IN
Zip : 46383-4836
Country : US
Telephone Number : 219-689-7632
Fax Number : 219-462-4741
Provider Business Practice Location Address
First Line : 8 MORGAN BLVD
Second Line :
City : VALPARAISO
State : IN
Zip : 46383-4836
Country : US
Telephone Number : 219-689-7632
Fax Number : 219-462-4741
Authorized Official
Title or Position : PRESIDENT
Name : DR. TIFFANY D SIMPSON
Credential : PSYD
Telephone Number : 219-689-7632
Provider Enumeration Date : 09/02/2010
Last Update Date : 09/02/2010

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Directions to “CREATIVE INTERVENTIONS COUNSELING, INC ” Practice Location

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