{"npi":"1720544463","type":"NPI-2","status":"active","name":{"display":"Creative Space Online Counseling And Coaching, LLC","other":[],"organization_name":"CREATIVE SPACE ONLINE COUNSELING AND COACHING, LLC","authorised_official":"Barbara Maulding"},"specialty":{"primary_taxonomy":"101YP2500X","primary_taxonomy_description":"Professional Counselor","slug":"professional-counselor","schema_org_specialty":null,"all":[{"code":"101YP2500X","description":"Professional Counselor","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"1566 SKYRIDGE DR UNIT 2","city":"CRYSTAL LAKE","state":"IL","postal_code":"600141027","country_code":"US","phone":"2246232251"},{"purpose":"MAILING","street_1":"1566 SKYRIDGE DR UNIT 2","city":"CRYSTAL LAKE","state":"IL","postal_code":"600141027","country_code":"US","phone":"2246232251"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"218215315001","state":"IL","issuer":null},{"type_code":"01","label":"Other","value":"180010906","state":"IL","issuer":"IDFPR"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20240424003630","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"IL","pac_id":"6002256054"}]},"enumeration_date":"2019-02-19","last_updated":"2024-03-13","_meta":{"source":"NPPES","snapshot_date":"2024-03-13","doc_url":"https://findmynpi.com/api"}}