Provider Demographics
NPI:1316626260
Name:CREATIVE RESOURCES CONSULTATION CENTER, INC.
Entity type:Organization
Organization Name:CREATIVE RESOURCES CONSULTATION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:NUSS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-993-0200
Mailing Address - Street 1:174 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-2024
Mailing Address - Country:US
Mailing Address - Phone:516-993-0200
Mailing Address - Fax:516-783-7957
Practice Address - Street 1:174 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-2024
Practice Address - Country:US
Practice Address - Phone:516-993-0200
Practice Address - Fax:516-783-7957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty