Organization
CREATIVE PARADIGM THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AGNES MELISSA IBANEZ LPC (PROVIDER)
(402) 203-6243
Entity
Organization
Contact information
Practice address
8011 CHICAGO ST, OMAHA, NE 68114-3533
(402) 517-5773
(402) 551-4724
Mailing address
8011 CHICAGO ST, OMAHA, NE 68114-3533
(402) 517-5773
(402) 551-4724
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/26/2010
Last updated
09/12/2023
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