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NPI Code Detail

MEDICARE: CREATIVE HEALING MENTAL HEALTH CENTER LLC

MEDICARE: CREATIVE HEALING MENTAL HEALTH CENTER 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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1346960366
Entity Type Code : Organization
Provider Name (Legal Business Name) : CREATIVE HEALING MENTAL HEALTH CENTER LLC
Provider Business Mailing Address
First Line : 1791 COUNTY HIGHWAY OO
Second Line :
City : CHIPPEWA FALLS
State : WI
Zip : 54729-5347
Country : US
Telephone Number : 715-797-2770
Fax Number :
Provider Business Practice Location Address
First Line : 1791 COUNTY HIGHWAY OO
Second Line :
City : CHIPPEWA FALLS
State : WI
Zip : 54729-5347
Country : US
Telephone Number : 715-829-0602
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JENIFER OLSON
Credential : LCSW
Telephone Number : 715-829-0602
Provider Enumeration Date : 08/30/2022
Last Update Date : 01/09/2024

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Directions to “CREATIVE HEALING MENTAL HEALTH CENTER LLC ” Practice Location

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