Provider Demographics
NPI:1295430353
Name:ALL THINGS CREATIVE THERAPY LLC
Entity type:Organization
Organization Name:ALL THINGS CREATIVE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LCPC
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLBROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:330-501-7658
Mailing Address - Street 1:1786 MAHONING RD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44411-9785
Mailing Address - Country:US
Mailing Address - Phone:330-501-7658
Mailing Address - Fax:
Practice Address - Street 1:6490 STATE ROUTE 14
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-9692
Practice Address - Country:US
Practice Address - Phone:330-501-7658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-30
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty