Provider Demographics
NPI:1083789580
Name:CREATIVE SOLUTIONS COUNSELING
Entity Type:Organization
Organization Name:CREATIVE SOLUTIONS COUNSELING
Other - Org Name:CREATIVE SOLUTIONS COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:805-904-6210
Mailing Address - Street 1:1540 MARSH ST STE 230
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-2984
Mailing Address - Country:US
Mailing Address - Phone:805-904-6210
Mailing Address - Fax:805-975-0771
Practice Address - Street 1:1540 MARSH ST STE 230
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2984
Practice Address - Country:US
Practice Address - Phone:805-904-6210
Practice Address - Fax:805-975-0771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35054106H00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========Medicare UPIN