Provider Demographics
NPI:1376371872
Name:CREATIVE UNBOUND COUNSELING LLC
Entity type:Organization
Organization Name:CREATIVE UNBOUND COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:CARLEY
Authorized Official - Last Name:BERNARDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-779-3870
Mailing Address - Street 1:1776 S JACKSON ST STE 700
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3806
Mailing Address - Country:US
Mailing Address - Phone:303-535-1921
Mailing Address - Fax:
Practice Address - Street 1:1776 S JACKSON ST STE 700
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3806
Practice Address - Country:US
Practice Address - Phone:303-535-1921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health