Provider Demographics
NPI:1578612057
Name:CREATIVE COUNSELING, INC
Entity Type:Organization
Organization Name:CREATIVE COUNSELING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:972-248-7722
Mailing Address - Street 1:5168 VILLAGE CREEK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4447
Mailing Address - Country:US
Mailing Address - Phone:972-248-7722
Mailing Address - Fax:972-248-7048
Practice Address - Street 1:5168 VILLAGE CREEK DR STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4447
Practice Address - Country:US
Practice Address - Phone:972-248-7722
Practice Address - Fax:972-248-7048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty