Organization
CREATIVE THERAPISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY INTILLI MERTENS LPC, ATR-BC (PROFESSIONAL COUNSELOR/OWNER)
(201) 320-5841
Entity
Organization
Contact information
Practice address
149 AVENUE AT THE CMN STE 4, SHREWSBURY, NJ 07702-4583
(201) 310-5841
Mailing address
PO BOX 6424, FAIR HAVEN, NJ 07704-6424
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37PC00635900
LICENSE NUMBER
NJ
Enumeration date
01/08/2020
Last updated
08/28/2020
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