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General NPI Number Information
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NPI Number | 1598987075
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Entity Type | Organization
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Legal Business Name | CREATIVE BEHAVIORAL SOLUTIONS
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 597 INDUSTRIAL DR SUITE 102
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City | CARMEL
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State | IN
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Zip | 46032-4207
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Country | US
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Telephone | 317-850-4129
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Fax |
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Provider Business Mailing Address
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Address Line | 597 INDUSTRIAL DR SUITE 102
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City | CARMEL
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State | IN
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Zip | 46032-4207
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Country | US
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Telephone | 317-850-4129
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LORI JANE ANDERSON
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Credential | LCSW
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Telephone | 317-850-4129
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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 | 34003716A
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License Number State | IN
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