Provider Demographics
NPI:1689016735
Name:RICHMOND CREATIVE COUNSELING
Entity Type:Organization
Organization Name:RICHMOND CREATIVE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, RPT-S
Authorized Official - Phone:804-592-6311
Mailing Address - Street 1:1900 BYRD AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3033
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1900 BYRD AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3033
Practice Address - Country:US
Practice Address - Phone:804-592-6311
Practice Address - Fax:804-237-0532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004199101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty