Provider Demographics
NPI:1154969863
Name:CREATIVE HARMONY CLINICAL SERVICES, LLC
Entity type:Organization
Organization Name:CREATIVE HARMONY CLINICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNTA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-892-4215
Mailing Address - Street 1:309 TERRACE AVE APT 13
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-2618
Mailing Address - Country:US
Mailing Address - Phone:203-892-4215
Mailing Address - Fax:
Practice Address - Street 1:2911 DIXWELL AVE STE B-11
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3152
Practice Address - Country:US
Practice Address - Phone:203-533-2276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty