Provider Demographics
NPI:1942895073
Name:CREATIVE ENERGY COUNSELING SERVICES L.L.C,
Entity Type:Organization
Organization Name:CREATIVE ENERGY COUNSELING SERVICES L.L.C,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:VERNAIZE
Authorized Official - Middle Name:K
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:646-234-2305
Mailing Address - Street 1:620 LENOX AVENUE
Mailing Address - Street 2:SUITE 1J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037
Mailing Address - Country:US
Mailing Address - Phone:646-234-2305
Mailing Address - Fax:
Practice Address - Street 1:620 LENOX AVENUE
Practice Address - Street 2:SUITE # 1J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037
Practice Address - Country:US
Practice Address - Phone:646-234-2305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty