MEDICARE: CREATIVE MIND HEALTH, LLC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1336013986
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREATIVE MIND HEALTH, LLC

Provider Business Mailing Address
First Line	:	6311 AMES AVE # 1061
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68104-2027
Country	:	US
Telephone Number	:	531-242-8821
Fax Number	:

Provider Business Practice Location Address
First Line	:	7280 NW 87TH TER STE C210
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64153-3720
Country	:	US
Telephone Number	:	913-395-3300
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL SUPERVISOR
Name	:	MS. JESSICA L WATERS
Credential	:	LADC
Telephone Number	:	531-242-8821

Provider Enumeration Date	:	10/06/2025
Last Update Date	:	02/06/2026

Similar Medicare Providers

1720554421 — ASHLEY MARIE CRUZ BCBA
Practice Location Address:

7280 NW 87TH TERRACE , SUITE C-210
KANSAS CITY, MO
64153-3720

Practice Phone: 855-832-6727
Practice Fax:

1760541684 — DR. HERMAN H LUCKE PH D
Practice Location Address:

7280 NW 87TH TER , SUITE 210
KANSAS CITY, MO
64153-3720

Practice Phone: 816-587-2626
Practice Fax: 816-587-2627

1932303609 — MRS. SARA K. WILPER LCSW
Practice Location Address:

7280 NW 87TH TER STE C-210
KANSAS CITY, MO
64153-3720

Practice Phone: 816-572-3845
Practice Fax:

1821254061 — JACQUELINE ELAINE KEITEL LCSW, LSCSW
Practice Location Address:

7280 NW 87TH TER , SUITE 210
KANSAS CITY, MO
64153-3720

Practice Phone: 816-872-2463
Practice Fax: 816-533-7220

1023336765 — DR. FARRELL S. WEIERS PHD
Practice Location Address:

7280 NW 87TH TER , SUITE 210
KANSAS CITY, MO
64153-3720

Practice Phone: 816-841-7929
Practice Fax: 816-841-7701

1972811578 — PEP PHYSICAL & EMOTIONAL POWER FOR LIFE, LLC
Practice Location Address:

7280 NW 87TH TER , #210
KANSAS CITY, MO
64153-3720

Practice Phone: 816-872-2463
Practice Fax: 816-533-7220

Directions to “CREATIVE MIND HEALTH, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.