Organization
CREATIVE RENEWAL & RESOLUTIONS, LLC
Active
Other names
Creative Renewal & Resolutions
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L BLACK PSYD, LCSW (OWNER, MANAGING MEMBER)
(417) 890-4083
Entity
Organization
Contact information
Practice address
1531 E BRADFORD PKWY, STE 210-4, SPRINGFIELD, MO 65804-6566
(417) 890-4083
(417) 890-4091
Mailing address
1531 E BRADFORD PKWY, STE 210-4, SPRINGFIELD, MO 65804-6566
(417) 890-4083
(417) 890-4091
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
2009026793
MO
103TB0200X
Cognitive & Behavioral Psychologist
2009026793
MO
103TC0700X
Clinical Psychologist
2009026793
MO
103TC1900X
Counseling Psychologist
2009026793
MO
103TC2200X
Clinical Child & Adolescent Psychologist
2009026793
MO
103TH0100X
Health Service Psychologist
Primary
2009026793
MO
103TP2701X
Group Psychotherapy Psychologist
2009026793
MO
1041C0700X
Clinical Social Worker
2001004284
MO
106H00000X
Marriage & Family Therapist
2001004284
MO
Other
Enumeration date
04/21/2011
Last updated
04/21/2011
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