Provider Demographics
NPI:1013603778
Name:CREATIVE HORIZONS COUNSELING
Entity Type:Organization
Organization Name:CREATIVE HORIZONS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MORRISON-WESELOH
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCC, ATR-BC
Authorized Official - Phone:763-742-2524
Mailing Address - Street 1:18436 230TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:BIG LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55309-8940
Mailing Address - Country:US
Mailing Address - Phone:763-742-2524
Mailing Address - Fax:
Practice Address - Street 1:690 HUMBOLDT DR
Practice Address - Street 2:
Practice Address - City:BIG LAKE
Practice Address - State:MN
Practice Address - Zip Code:55309-4812
Practice Address - Country:US
Practice Address - Phone:763-742-2524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty