Provider Demographics
NPI:1083361323
Name:CREATIVE SOLUTIONS COUNSELING LLC
Entity Type:Organization
Organization Name:CREATIVE SOLUTIONS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:LATIN-KASPER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-IT
Authorized Official - Phone:262-834-9013
Mailing Address - Street 1:1025 W GLEN OAKS LN STE 109
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-3372
Mailing Address - Country:US
Mailing Address - Phone:262-834-9013
Mailing Address - Fax:262-236-9805
Practice Address - Street 1:1025 W GLEN OAKS LN STE 109
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-3372
Practice Address - Country:US
Practice Address - Phone:414-737-0168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-07
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health