CREATIVE CHANGE, LLC
NPI 1760515498
Psychologist - Clinical in Ellisville, MO

Q: What is Creative Change, LLC's NPI number?

The NPI number for Creative Change, LLC is 1760515498. It was assigned to this organization in the NPPES registry on March 13, 2007.

Q: What is Creative Change, LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since March 13, 2007

177 CLARKSON EXECUTIVE PARK, ELLISVILLE, MO 63011(314) 962-7788 Get Directions Write a Review

NPPES record last updated: September 17, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 17, 2025, Dec 6, 2024, Aug 22, 2020 (3 updates tracked since 2020).

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About Creative Change, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CREATIVE CHANGE, LLC (NPI 1760515498) is a healthcare organization registered as a clinical in Ellisville, Missouri and active in the NPI registry since March 2007. The organization maintains a secondary practice location in Saint Louis and lists Rhonda Stewart, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1760515498

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameCREATIVE CHANGE, LLC

Location Address177 CLARKSON EXECUTIVE PARKEllisville, MO 63011-2176

Mailing Address177 Clarkson Executive ParkEllisville, MO 63011-2176 · (314) 962-7788 · Fax (314) 962-4158

Phone(314) 962-7788

Organization SubpartNo

Authorized OfficialRhonda StewartBilling Manager · (636) 893-8949

Enumeration DateMarch 13, 2007

Last NPPES UpdateSeptember 17, 20253 updates tracked since enumeration

NPPES CertifiedSeptember 17, 2025

✔ NPI 1760515498 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

177 CLARKSON EXECUTIVE PARK, Ellisville, MO 63011

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Secondary Practice Location 1

Location 18772 Big Bend BlvdSaint Louis, MO 63119-3730 · Phone (314) 962-7788 · Fax (314) 962-4158

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Creative Change, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 4 clinicians reassign Medicare billing to Creative Change, LLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (4)

Robert Rosen, MSW

Clinical Social Worker

NPI 1265560734

11715 ADMINISTRATION DRIVE SUITE 101
Saint Louis, MO 63146

(314) 853-0944

✔ PECOS11 mi

Timothy Jovick, PHD

Clinical Psychologist

NPI 1174620793

8772 BIG BEND BLVD
Saint Louis, MO 63119

(314) 962-7788

✔ PECOS✔ Accepts Medicare12 mi

Patricia Boever, PSYCHOLOGIST

Clinical Psychologist

NPI 1073568069

8772 BIG BEND BLVD
Saint Louis, MO 63119

(314) 962-7788

✔ PECOS✔ Accepts Medicare12 mi

Michael Krownapple, PSY.D.

Clinical Psychologist

NPI 1568779189

1010 W COLUMBIA ST
Farmington, MO 63640

(573) 218-6040

✔ PECOS✔ Accepts Medicare58 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Creative Change, LLC's NPI number?

The NPI number for Creative Change, LLC is 1760515498. It was assigned to this organization in the NPPES registry on March 13, 2007.

Where is Creative Change, LLC located?

Creative Change, LLC is located at 177 Clarkson Executive Park, Ellisville, MO 63011. The listed phone number is (314) 962-7788.

What is Creative Change, LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Creative Change, LLC enrolled in Medicare?

Yes. Creative Change, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Creative Change, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Creative Change, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Psychologist (3) and Clinical Social Worker (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Creative Change, LLC accept?

Health plans from Anthem Blue Cross and Blue Shield list Creative Change, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Creative Change, LLC was last updated on September 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.