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General NPI Number Information
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NPI Number | 1851720221
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Entity Type | Organization
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Legal Business Name | CREATIVE SOLUTIONS THERAPY, LLC
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Dates
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Enumeration Date | 11/06/2013
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Last Update Date | 11/06/2013
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Provider Practice Location Address
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Address Line | 363 CENTRE ST
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City | NUTLEY
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State | NJ
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Zip | 07110-4706
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Country | US
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Telephone | 973-908-1272
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Fax |
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Provider Business Mailing Address
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Address Line | 363 CENTRE ST
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City | NUTLEY
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State | NJ
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Zip | 07110-4706
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Country | US
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Telephone | 973-908-1272
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VALERIE MICHALOWSKI
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Credential | LCSW, MT-BC
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Telephone | 973-908-1272
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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 | 44SC05448300
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License Number State | NJ
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