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General NPI Number Information
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NPI Number | 1992026405
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Entity Type | Organization
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Legal Business Name | CREATIVE THERAPY SERVICES
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Dates
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Enumeration Date | 06/18/2010
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Last Update Date | 08/06/2014
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Provider Practice Location Address
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Address Line | 1546 BLACKWOOD CLEMENTON RD
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City | BLACKWOOD
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State | NJ
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Zip | 08012-4626
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Country | US
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Telephone | 856-232-4770
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Fax |
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Provider Business Mailing Address
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Address Line | 1546 BLACKWOOD CLEMENTON RD PO BOX 173
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City | BLACKWOOD
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State | NJ
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Zip | 08012-4626
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Country | US
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Telephone | 856-232-4770
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MICHELLE ROBIN CARLAMERE
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Credential | LCSW
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Telephone | 856-232-4770
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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 | 44SC0523188
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License Number State | NJ
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