Healthcare Provider Details

I. General information

NPI: 1215448584
Provider Name (Legal Business Name): CREATIVE PERSPECTIVES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2017
Last Update Date: 10/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 W CATAWBA AVE
MOUNT HOLLY NC
28120-1601
US

IV. Provider business mailing address

PO BOX 94
MC ADENVILLE NC
28101-0094
US

V. Phone/Fax

Practice location:
  • Phone: 704-759-6525
  • Fax:
Mailing address:
  • Phone: 704-759-6525
  • Fax:

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: BARBARA BROWN
Title or Position: OWNER
Credential: MSW
Phone: 704-759-6525