1285289629 NPI number — CENTER FOR CREATIVE VALUES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285289629 NPI number — CENTER FOR CREATIVE VALUES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTER FOR CREATIVE VALUES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285289629
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/01/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
40 YORK ROAD
Provider Second Line Business Mailing Address:
SUITE 250, #6
Provider Business Mailing Address City Name:
TOWSON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-337-0938
Provider Business Mailing Address Fax Number:
410-337-2104

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
515 E. JOPPA RD SUITE 100 & 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOWSON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21286
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-337-0938
Provider Business Practice Location Address Fax Number:
410-337-2104
Provider Enumeration Date:
08/02/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ATOLOYE
Authorized Official First Name:
KAY
Authorized Official Middle Name:
Authorized Official Title or Position:
PROGRAM DIRECTOR
Authorized Official Telephone Number:
443-929-8315

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)