Provider Demographics
NPI:1811546476
Name:CREATING CONNECTIONS COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:CREATING CONNECTIONS COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:INSKEEP
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:614-949-5078
Mailing Address - Street 1:15 W CENTRAL AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-1953
Mailing Address - Country:US
Mailing Address - Phone:614-949-5078
Mailing Address - Fax:
Practice Address - Street 1:15 W CENTRAL AVE STE 103
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1953
Practice Address - Country:US
Practice Address - Phone:614-949-5078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)