Provider Demographics
NPI:1639986904
Name:CREATIVE PRESENCE COUNSELING LLC
Entity type:Organization
Organization Name:CREATIVE PRESENCE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:503-686-9903
Mailing Address - Street 1:1100 SW 170TH AVE UNIT 201
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97003-8093
Mailing Address - Country:US
Mailing Address - Phone:503-686-9903
Mailing Address - Fax:
Practice Address - Street 1:1100 SW 170TH AVE UNIT 201
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97003-8093
Practice Address - Country:US
Practice Address - Phone:503-686-9903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty