| Creating Space Therapy, Pllc | |
|
34 N Island Ave Ste F Batavia IL 60510-1996 | |
| (630) 601-3460 | |
| (331) 422-2912 |
| Full Name | Creating Space Therapy, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 34 N Island Ave Ste F, Batavia, Illinois |
| Authorized Official Name and Position | Kelly Huggins (OWNER) |
| Authorized Official Contact | 6306013459 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Creating Space Therapy, Pllc 34 N Island Ave Ste F Batavia IL 60510-1996 Ph: (630) 601-3460 | Creating Space Therapy, Pllc 34 N Island Ave Ste F Batavia IL 60510-1996 Ph: (630) 601-3460 |
| NPI Number | 1285232058 |
|---|---|
| Provider Enumeration Date | 10/14/2020 |
| Last Update Date | 08/23/2021 |
| Certification Date | 08/23/2021 |
| Medicare PECOS PAC ID | 3274948617 |
|---|---|
| Medicare Enrollment ID | O20210218000100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285232058 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kelly Huggins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609019306 PECOS PAC ID: 1850416892 Enrollment ID: I20100915000302 |
| Provider Name | Charlotte Jeanne Shuber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164109880 PECOS PAC ID: 5193170595 Enrollment ID: I20231004002520 |
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