Provider Demographics
NPI:1952907610
Name:CREATIVE HEALERS, LLC
Entity Type:Organization
Organization Name:CREATIVE HEALERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:TOBEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA LLP
Authorized Official - Phone:734-968-6480
Mailing Address - Street 1:650 CHURCH ST RM 313
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1689
Mailing Address - Country:US
Mailing Address - Phone:734-215-7202
Mailing Address - Fax:856-997-1717
Practice Address - Street 1:650 CHURCH ST RM 313
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1689
Practice Address - Country:US
Practice Address - Phone:734-215-7202
Practice Address - Fax:856-997-1717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty