Provider Demographics
NPI:1710130430
Name:CREATIVE COUNSELING ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:CREATIVE COUNSELING ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER-WEINER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LSW
Authorized Official - Phone:724-873-1220
Mailing Address - Street 1:20 E PIKE ST
Mailing Address - Street 2:SUITE LLA
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-1366
Mailing Address - Country:US
Mailing Address - Phone:724-873-1220
Mailing Address - Fax:412-276-5195
Practice Address - Street 1:20 E PIKE ST
Practice Address - Street 2:SUITE LLA
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-1366
Practice Address - Country:US
Practice Address - Phone:724-873-1220
Practice Address - Fax:412-276-5195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-25
Last Update Date:2008-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW009543L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty