Organization
CREATIVE PATHWAYS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JENNIFER E FISHER LCSW, MSSW (OWNER)
(502) 552-3107
Entity
Organization
Contact information
Practice address
639 EASTERN BLVD, SUITE F, CLARKSVILLE, IN 47129-2460
(502) 552-3107
Mailing address
608 HOPKINS LN, JEFFERSONVILLE, IN 47130-5034
(502) 552-3107
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
34003596A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639175771
INDIVIDUAL NPI (TYPE I)
IN
Enumeration date
03/20/2009
Last updated
03/20/2009
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