Organization
CREATIVE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LYNN EBERLE LPC, NCC (COUNSELOR)
(701) 367-8293
Entity
Organization
Contact information
Practice address
323 CENTRAL AVE N, SUITE 203, VALLEY CITY, ND 58072-2915
(701) 367-8293
Mailing address
323 CENTRAL AVE N, SUITE 203, VALLEY CITY, ND 58072-2915
(701) 367-8293
(701) 490-3283
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
694-8-1-11
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1455895
—
ND
05
—
1462435
—
ND
Enumeration date
07/16/2014
Last updated
11/09/2015
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