Provider Demographics
NPI:1770257677
Name:PUZZLE PEACE CREATIVE COUNSELING SOLUTIONS
Entity type:Organization
Organization Name:PUZZLE PEACE CREATIVE COUNSELING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-674-3499
Mailing Address - Street 1:304 E MAIN ST STE 5
Mailing Address - Street 2:
Mailing Address - City:WILMORE
Mailing Address - State:KY
Mailing Address - Zip Code:40390-1375
Mailing Address - Country:US
Mailing Address - Phone:888-816-1469
Mailing Address - Fax:859-788-2014
Practice Address - Street 1:304 E MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:WILMORE
Practice Address - State:KY
Practice Address - Zip Code:40390-1375
Practice Address - Country:US
Practice Address - Phone:888-816-1469
Practice Address - Fax:859-788-2014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty