Provider Demographics
NPI:1023747318
Name:CREECH, EDWARD RICHELY (MED, LPC 070101074)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:RICHELY
Last Name:CREECH
Suffix:
Gender:M
Credentials:MED, LPC 070101074
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19
Mailing Address - Street 2:
Mailing Address - City:PARTRIDGE
Mailing Address - State:KY
Mailing Address - Zip Code:40862-0019
Mailing Address - Country:US
Mailing Address - Phone:606-733-0614
Mailing Address - Fax:
Practice Address - Street 1:PC 310 CLOVERLEAF SQUARE
Practice Address - Street 2:STE B2
Practice Address - City:BIGSTONE GAP
Practice Address - State:VA
Practice Address - Zip Code:24219
Practice Address - Country:US
Practice Address - Phone:276-409-5055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-10
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010740101YM0800X, 101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health