Provider Demographics
NPI:1710144027
Name:CREEL, FAYE RUTH (LPC)
Entity Type:Individual
Prefix:MS
First Name:FAYE
Middle Name:RUTH
Last Name:CREEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 OLD CAMP CHURCH ROAD
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-8291
Mailing Address - Country:US
Mailing Address - Phone:770-836-1332
Mailing Address - Fax:
Practice Address - Street 1:707 OLD CAMP CHURCH ROAD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-8291
Practice Address - Country:US
Practice Address - Phone:770-836-1332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC000599101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health