Provider Demographics
NPI:1386153617
Name:CREATIVE BEHAVIOR THERAPY, INC
Entity type:Organization
Organization Name:CREATIVE BEHAVIOR THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:MARIAM
Authorized Official - Last Name:ARAUJO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:786-337-1451
Mailing Address - Street 1:5249 NW 7TH ST APT 413
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3378
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5249 NW 7TH ST APT 413
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3378
Practice Address - Country:US
Practice Address - Phone:786-337-1451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-29
Last Update Date:2017-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW9757103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty