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General NPI Number Information
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NPI Number | 1659019495
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Entity Type | Organization
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Legal Business Name | CREATIVE EMPOWERMENT CLINICAL SERVICES
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Dates
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Enumeration Date | 05/23/2022
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Last Update Date | 05/23/2022
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Provider Practice Location Address
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Address Line | RHODE ISLAND AVE #254
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City | BELTSVILLE
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State | MD
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Zip | 20704-0254
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Country | US
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Telephone | 202-430-6116
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Fax |
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Provider Business Mailing Address
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Address Line | RHODE ISLAND AVE #254
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City | BELTSVILLE
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State | MD
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Zip | 20704
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Country | US
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Telephone | 202-430-6116
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA RICE
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Credential | LCPC
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Telephone | 202-430-6116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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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 | 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 #5
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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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