Provider Demographics
NPI:1598370819
Name:CREATING BOUNDARIES, LLC
Entity Type:Organization
Organization Name:CREATING BOUNDARIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SULFRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:859-488-1096
Mailing Address - Street 1:PO BOX 523
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40476-0523
Mailing Address - Country:US
Mailing Address - Phone:859-488-1096
Mailing Address - Fax:859-986-4975
Practice Address - Street 1:200 E MAIN ST STE 208
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-1628
Practice Address - Country:US
Practice Address - Phone:488-488-1096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty