Provider Demographics
NPI:1760184436
Name:CREATIVE ALCHEMY COUNSELING
Entity Type:Organization
Organization Name:CREATIVE ALCHEMY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, ATR-BC, ATCS
Authorized Official - Phone:872-888-7958
Mailing Address - Street 1:5215 N RAVENSWOOD AVE STE 312
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-1670
Mailing Address - Country:US
Mailing Address - Phone:872-888-7958
Mailing Address - Fax:
Practice Address - Street 1:5215 N RAVENSWOOD AVE STE 312
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-1670
Practice Address - Country:US
Practice Address - Phone:872-888-7958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty