Provider Demographics
NPI:1508266602
Name:COUNSELING FOR CREATIVES
Entity Type:Organization
Organization Name:COUNSELING FOR CREATIVES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:AYCOCK
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LGMFT, NCC
Authorized Official - Phone:240-429-3559
Mailing Address - Street 1:3402 HICKORY AVE
Mailing Address - Street 2:APT. 1
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2458
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1107 KENILWORTH DR
Practice Address - Street 2:SUITE 208
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2140
Practice Address - Country:US
Practice Address - Phone:443-687-9951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGM505106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty