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General NPI Number Information
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NPI Number | 1396556833
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Entity Type | Organization
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Legal Business Name | CREATIVE LICENSED MARRIAGE AND FAMILY THERAPIST, INC.
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 150 N SANTA ANITA AVE STE 800
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City | ARCADIA
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State | CA
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Zip | 91006-3129
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Country | US
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Telephone | 626-214-8606
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Fax |
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Provider Business Mailing Address
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Address Line | 150 N SANTA ANITA AVE STE 800
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City | ARCADIA
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State | CA
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Zip | 91006-3129
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHAO ZHAO
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Credential |
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Telephone | 626-362-5040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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