Provider Demographics
NPI:1962867440
Name:CREATIVE COUNSELING SOLUTIONS
Entity Type:Organization
Organization Name:CREATIVE COUNSELING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:LAMONT
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-309-5411
Mailing Address - Street 1:9 WINDSOR GLEN DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6601
Mailing Address - Country:US
Mailing Address - Phone:919-309-5411
Mailing Address - Fax:
Practice Address - Street 1:601 FAYETTEVILLE ST
Practice Address - Street 2:SUITE 300
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-4459
Practice Address - Country:US
Practice Address - Phone:919-309-5411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-28
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health