Provider Demographics
NPI:1659172435
Name:CREATIVE COLLABORATIVE THERAPY LLC
Entity type:Organization
Organization Name:CREATIVE COLLABORATIVE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:KATHERINE HINTZ
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:816-738-1689
Mailing Address - Street 1:4024 W WILDERNESS ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5687
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1722 S GLENSTONE AVE STE NN
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1516
Practice Address - Country:US
Practice Address - Phone:417-708-0220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)