Healthcare Provider Details

I. General information

NPI: 1487721635
Provider Name (Legal Business Name): CREATIVE HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

452 PENN ST
PENNSBURG PA
18073-1106
US

IV. Provider business mailing address

11 ROBINSON ST
POTTSTOWN PA
19464-6421
US

V. Phone/Fax

Practice location:
  • Phone: 610-326-9250
  • Fax: 215-679-9795
Mailing address:
  • Phone: 484-941-0500
  • Fax: 484-941-0515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number132260
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number132260
License Number StatePA

VIII. Authorized Official

Name: DR. P. ANDREW TRENTACOSTE
Title or Position: EXECUTIVE DIRECTOR
Credential: PHY.D., MBA
Phone: 484-941-0500