Provider Demographics
NPI:1013668581
Name:CREATIVE AESTHETICS LLC
Entity Type:Organization
Organization Name:CREATIVE AESTHETICS LLC
Other - Org Name:NEXT STEP RECOVERY AZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:602-781-4176
Mailing Address - Street 1:18151 W CARLOTA LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85387-1552
Mailing Address - Country:US
Mailing Address - Phone:602-781-4176
Mailing Address - Fax:
Practice Address - Street 1:18151 W CARLOTA LN
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85387-1552
Practice Address - Country:US
Practice Address - Phone:480-267-0315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-15
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ122470Medicaid
AZ123956Medicaid