Provider Demographics
NPI:1033470331
Name:THE CENTER FOR CREATIVE FUTURES
Entity Type:Organization
Organization Name:THE CENTER FOR CREATIVE FUTURES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:321-212-8651
Mailing Address - Street 1:3370 NE 190TH ST APT 606
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2410
Mailing Address - Country:US
Mailing Address - Phone:786-315-9355
Mailing Address - Fax:
Practice Address - Street 1:3370 NE 190TH ST APT 606
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-2410
Practice Address - Country:US
Practice Address - Phone:786-315-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 6814101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty