Provider Demographics
NPI:1629191812
Name:HEALING TRANSITIONS CREATIVE COUNSELING FOR CHILDREN & FAMILIES INC.
Entity Type:Organization
Organization Name:HEALING TRANSITIONS CREATIVE COUNSELING FOR CHILDREN & FAMILIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:CRAVEN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:850-838-7866
Mailing Address - Street 1:3333 CLARK RD STE 170
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-8435
Mailing Address - Country:US
Mailing Address - Phone:850-838-7866
Mailing Address - Fax:888-700-6760
Practice Address - Street 1:3333 CLARK RD STE 170
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-8435
Practice Address - Country:US
Practice Address - Phone:941-888-2081
Practice Address - Fax:888-700-6760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL001179700251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023731700Medicaid