Healthcare Provider Details

I. General information

NPI: 1285289629
Provider Name (Legal Business Name): CENTER FOR CREATIVE VALUES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2019
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 YORK ROAD SUITE 250, UNIT 6
TOWSON MD
21204
US

IV. Provider business mailing address

40 YORK ROAD SUITE 250, #6
TOWSON MD
21204
US

V. Phone/Fax

Practice location:
  • Phone: 410-337-0938
  • Fax: 410-337-2104
Mailing address:
  • Phone: 410-337-0938
  • Fax: 410-337-2104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. KAY ATOLOYE
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 443-929-8315