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CREATIVE RENEWAL & RESOLUTIONS LLC NPI 1184915472


NPI Information

NPI: 1184915472
Provider Name: CREATIVE RENEWAL & RESOLUTIONS, LLC

Doing Business As: CREATIVE RENEWAL & RESOLUTIONS

Classification: Psychologist - 103TH0100X
Entity Type: Organization

Specialization: Health Service

Address:
1531 E BRADFORD PKWY
STE 210-4
SPRINGFIELD, MO
ZIP 65804
Phone: (417) 890-4083
Get Directions

CREATIVE RENEWAL & RESOLUTIONS, LLC is a health service psychologist in Springfield, MO. The provider is a psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). CREATIVE RENEWAL & RESOLUTIONS, LLC NPI is 1184915472. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Creative Renewal & Resolutions.

The provider's business location address is:

1531 E BRADFORD PKWY
STE 210-4
SPRINGFIELD, MO
ZIP 65804-566
Phone: (417) 890-4083
Fax: (417) 890-4091

The provider's authorized official is David L Black .
The authorized official title is Owner, Managing Member and has the following contact phone number (417) 890-4083.

The enumeration date for this NPI number is 4/21/2011 and was last updated on 4/21/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TA0400XPsychologistAddiction (Substance Use Disorder)2009026793MISSOURINo
2103TB0200XPsychologistCognitive & Behavioral2009026793MISSOURINo
3103TC0700XPsychologistClinical2009026793MISSOURINo
4103TC1900XPsychologistCounseling2009026793MISSOURINo
5103TC2200XPsychologistClinical Child & Adolescent2009026793MISSOURINo
6103TP2701XPsychologistGroup Psychotherapy2009026793MISSOURINo
71041C0700XSocial WorkerClinical2001004284MISSOURINo
8106H00000XMarriage & Family Therapist2001004284MISSOURINo
9103TH0100XPsychologistHealth Service2009026793MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.