Provider Demographics
NPI:1154644318
Name:CREEK COUNSELING
Entity Type:Organization
Organization Name:CREEK COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:KALANA
Authorized Official - Last Name:CREEK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCPC
Authorized Official - Phone:406-282-3696
Mailing Address - Street 1:25 S EWING ST
Mailing Address - Street 2:SUITE 517
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-5938
Mailing Address - Country:US
Mailing Address - Phone:406-282-3696
Mailing Address - Fax:406-545-3940
Practice Address - Street 1:25 S EWING ST
Practice Address - Street 2:SUITE 517
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5938
Practice Address - Country:US
Practice Address - Phone:406-282-3696
Practice Address - Fax:406-545-3940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-9676251S00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025852400Medicaid