Provider Demographics
NPI:1205475878
Name:CREATIVE LIFE STRATEGIES, LLC
Entity type:Organization
Organization Name:CREATIVE LIFE STRATEGIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEOTTA-SELBY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,LCADC
Authorized Official - Phone:732-580-6619
Mailing Address - Street 1:PO BOX 110
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-0110
Mailing Address - Country:US
Mailing Address - Phone:732-580-6619
Mailing Address - Fax:732-228-7335
Practice Address - Street 1:625 ROUTE 9
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08722-4007
Practice Address - Country:US
Practice Address - Phone:732-580-6619
Practice Address - Fax:732-228-7335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty