=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730710765
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CC SPA & THE PAMPERING PEOPLE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/29/2020
-----------------------------------------------------
Last Update Date | 07/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7104 NOVAS LNDG
-----------------------------------------------------
City | SELLERSBURG
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47172-1899
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-528-0198
-----------------------------------------------------
Fax | 812-203-5678
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7104 NOVAS LNDG
-----------------------------------------------------
City | SELLERSBURG
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47172-1899
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-299-4256
-----------------------------------------------------
Fax | 812-203-5678
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BUSINESS OWNER
-----------------------------------------------------
Name | VALERIE JUNE BROOKS-TATE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 502-299-4256
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------