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General NPI Number Information
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NPI Number | 1487519070
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Entity Type | Organization
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Legal Business Name | CENTER FOR CREATIVE STUDIES LLC
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 8205 SPAIN RD NE STE 201
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-3130
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Country | US
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Telephone | 505-440-3226
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Fax | 505-275-5756
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Provider Business Mailing Address
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Address Line | 14109 GRAND AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87123-1802
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Country | US
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Telephone | 505-440-3226
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Fax | 505-275-7576
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Authorized Official
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Title or Position | CEO
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Name | CHRISTY TACKWELL
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Credential | LPCC LPAT ATR
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Telephone | 505-440-3226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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