Provider Demographics
NPI:1306401906
Name:CREATIVECOUNSELING LIVING & WELLNESS, LLC
Entity Type:Organization
Organization Name:CREATIVECOUNSELING LIVING & WELLNESS, LLC
Other - Org Name:GUIDEDSTEPS COUNSELING AND CONSULTING, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER & CEO
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BATTLE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, NCC, CFT
Authorized Official - Phone:407-951-4207
Mailing Address - Street 1:877 W MINNEOLA AVE UNIT 120946
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34712-7039
Mailing Address - Country:US
Mailing Address - Phone:407-951-4207
Mailing Address - Fax:321-348-2861
Practice Address - Street 1:1964 HOWELL BRANCH RD STE 110
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-1042
Practice Address - Country:US
Practice Address - Phone:407-951-4207
Practice Address - Fax:321-348-2861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-08
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty