Provider Demographics
NPI:1568850030
Name:CREATIVE HEALTH SERVICES PSYCHOLOGY GROUP, PC
Entity Type:Organization
Organization Name:CREATIVE HEALTH SERVICES PSYCHOLOGY GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:GARFINKEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:415-871-3799
Mailing Address - Street 1:2031 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-1245
Mailing Address - Country:US
Mailing Address - Phone:415-871-3799
Mailing Address - Fax:
Practice Address - Street 1:110 GOUGH ST STE 203
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102
Practice Address - Country:US
Practice Address - Phone:415-871-3799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-06
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty