Provider Demographics
NPI:1043796386
Name:CREEL, STEPHEN (MA, LMFT)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:CREEL
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:CREEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LMFT
Mailing Address - Street 1:4343 VON KARMAN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2098
Mailing Address - Country:US
Mailing Address - Phone:949-650-4334
Mailing Address - Fax:
Practice Address - Street 1:3822 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2627
Practice Address - Country:US
Practice Address - Phone:949-650-4334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44523106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist