Creasbaum, Tabatha

Creasbaum, Tabatha is an individual health care provider with primary practice located at 630 Cottonwood Dr , Dyer IN 46311-2207. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Creasbaum, Tabatha can be contacted via phone (219) 588-3540.

Contact Information

Primary practice address
630 Cottonwood Dr Dyer IN 46311-2207
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 39002363A Indiana

Profile Details

NPI number 1972831568
LBN Legal business name Creasbaum, Tabatha
Credentials LMHC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 19th, 2009
Last updated Jan 30th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972831568 NPPES
Indiana MEDICAID 201207560A

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