Provider Demographics
NPI:1861648925
Name:CREATIVE COUNSELING, LLC
Entity Type:Organization
Organization Name:CREATIVE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR AND MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LUCILLE
Authorized Official - Middle Name:C
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:203-207-9944
Mailing Address - Street 1:36 MILL PLAIN RD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-5181
Mailing Address - Country:US
Mailing Address - Phone:203-207-9944
Mailing Address - Fax:
Practice Address - Street 1:36 MILL PLAIN RD
Practice Address - Street 2:SUITE 306
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-5181
Practice Address - Country:US
Practice Address - Phone:203-207-9944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001430101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty