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General NPI Number Information
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NPI Number | 1215878236
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Entity Type | Organization
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Legal Business Name | THE CREATIVE SANCTUARY
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Dates
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Enumeration Date | 04/03/2026
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 11528 W STATE ROAD 84 # 551447
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City | DAVIE
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State | FL
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Zip | 33325-4022
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Country | US
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Telephone | 954-998-2538
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Fax |
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Provider Business Mailing Address
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Address Line | 11528 W STATE ROAD 84 # 551447
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City | DAVIE
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State | FL
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Zip | 33325-4022
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Country | US
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Telephone | 954-998-2538
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Fax |
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Authorized Official
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Title or Position | FOUNDER & THERAPIST
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Name | KAILEY KRUPAR
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Credential | MS, ATR-BC, LMHC
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Telephone | 954-998-2538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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