Provider Demographics
NPI:1952057242
Name:CREEKSIDE COUNSELING LLC
Entity Type:Organization
Organization Name:CREEKSIDE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-250-9917
Mailing Address - Street 1:26400 KUYKENDAHL RD STE C180-239
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77375-2882
Mailing Address - Country:US
Mailing Address - Phone:281-849-9691
Mailing Address - Fax:281-849-3870
Practice Address - Street 1:26400 KUYKENDAHL RD STE C180-239
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77375-2882
Practice Address - Country:US
Practice Address - Phone:281-849-9691
Practice Address - Fax:281-849-3870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty