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Organization
CREATIVE THERAPEUTICS, LLC
Active
Organization
CREATIVE THERAPEUTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN FRANCIS HENNESSEY L.C.S.W. (AGENT/MANAGER AND MEMBER)
(860) 429-2500
Entity
Organization
Contact information
Practice address
1066 STORRS RD, SUITE C, STORRS MANSFIELD, CT 06268-2648
(860) 429-2500
(860) 429-2501
Mailing address
140 CRANE HILL RD, STORRS MANSFIELD, CT 06268-2800
(860) 377-2996
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000568
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000568
STATE OF CT DEPARTMENT OF PUBLIC HEALTH
CT
Enumeration date
11/14/2008
Last updated
11/14/2008
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