Provider Demographics
NPI:1609196773
Name:CREEKVIEW COUNSELING PLLC
Entity Type:Organization
Organization Name:CREEKVIEW COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SAMFORD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:210-237-7163
Mailing Address - Street 1:4115 MEDICAL DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5657
Mailing Address - Country:US
Mailing Address - Phone:210-237-7163
Mailing Address - Fax:
Practice Address - Street 1:4115 MEDICAL DR
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5657
Practice Address - Country:US
Practice Address - Phone:210-237-7163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4940106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty