MEDICARE: CREATIVE LEARNING THERAPIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1275300113
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREATIVE LEARNING THERAPIES

Provider Business Mailing Address
First Line	:	7121 W CRAIG RD.
Second Line	:	STE 113 PMB 1047
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6186
Country	:	US
Telephone Number	:	702-526-7541
Fax Number	:

Provider Business Practice Location Address
First Line	:	7121 W CRAIG RD.
Second Line	:	STE 113 PMB 1047
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6186
Country	:	US
Telephone Number	:	702-526-7541
Fax Number	:

Authorized Official
Title or Position	:	CEO, BEHAVIOR ANALYST
Name	:	MRS. NYETTA SHANEE ABERNATHY
Credential	:	BCBA, LBA
Telephone Number	:	702-526-7541

Provider Enumeration Date	:	12/11/2023
Last Update Date	:	07/25/2025

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