Provider Demographics
NPI:1457906935
Name:CREATIVE CONCEPTS MENTAL HEALTH COUNSELING, PC
Entity Type:Organization
Organization Name:CREATIVE CONCEPTS MENTAL HEALTH COUNSELING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CASAC-MC
Authorized Official - Phone:631-921-8572
Mailing Address - Street 1:865 OLD COUNTRY RD # 148
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2106
Mailing Address - Country:US
Mailing Address - Phone:631-921-8572
Mailing Address - Fax:208-668-8975
Practice Address - Street 1:136 LA BONNE VIE DR W APT B
Practice Address - Street 2:
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-4564
Practice Address - Country:US
Practice Address - Phone:631-921-8572
Practice Address - Fax:208-668-8975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-02
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty