Provider Demographics
NPI:1043763949
Name:CREATIVE SOLUTIONS OF THE BLUEGRASS LLC
Entity Type:Organization
Organization Name:CREATIVE SOLUTIONS OF THE BLUEGRASS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:B
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, PHD
Authorized Official - Phone:859-229-1053
Mailing Address - Street 1:2039 REGENCY RD STE 1
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2334
Mailing Address - Country:US
Mailing Address - Phone:859-229-1053
Mailing Address - Fax:859-543-8116
Practice Address - Street 1:2039 REGENCY RD STE 1
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2334
Practice Address - Country:US
Practice Address - Phone:859-229-1053
Practice Address - Fax:859-543-8116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-27
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1196251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health