| Creative Storm Therapy, Llc | |
|
1111 55th St Ste 4 Kenosha WI 53140-3611 | |
| (262) 346-5913 | |
| Not Available |
| Full Name | Creative Storm Therapy, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1111 55th St Ste 4, Kenosha, Wisconsin |
| Authorized Official Name and Position | Lori Storm (OWNER) |
| Authorized Official Contact | 2623465913 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Storm Therapy, Llc 4308 Pennington Ln Mount Pleasant WI 53403-3960 Ph: (262) 346-5913 | Creative Storm Therapy, Llc 1111 55th St Ste 4 Kenosha WI 53140-3611 Ph: (262) 346-5913 |
| NPI Number | 1194442202 |
|---|---|
| Provider Enumeration Date | 10/20/2022 |
| Last Update Date | 10/20/2022 |
| Certification Date | 10/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194442202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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