Provider Demographics
NPI:1184334229
Name:CREATIVE HEALING PLLC
Entity type:Organization
Organization Name:CREATIVE HEALING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCPC, ATR-BC
Authorized Official - Phone:708-480-2022
Mailing Address - Street 1:1343 W IRVING PARK RD UNIT 13469
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-8323
Mailing Address - Country:US
Mailing Address - Phone:708-480-2022
Mailing Address - Fax:
Practice Address - Street 1:4620 N RACINE AVE APT 19
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-4900
Practice Address - Country:US
Practice Address - Phone:708-480-2022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)