Provider Demographics
NPI:1760930903
Name:CREATIVE BEHAVIORAL SOLUTIONS
Entity Type:Organization
Organization Name:CREATIVE BEHAVIORAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-710-6837
Mailing Address - Street 1:119 DRUM HILL RD # 124
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-1505
Mailing Address - Country:US
Mailing Address - Phone:978-710-6837
Mailing Address - Fax:978-710-6941
Practice Address - Street 1:119 DRUM HILL RD # 124
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1505
Practice Address - Country:US
Practice Address - Phone:978-710-6837
Practice Address - Fax:978-710-6941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty