Provider Demographics
NPI:1194587329
Name:CREATIVE COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:CREATIVE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SUSANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:FIELDS-KUEHL
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:240-394-8372
Mailing Address - Street 1:6001 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-2019
Mailing Address - Country:US
Mailing Address - Phone:301-795-8976
Mailing Address - Fax:
Practice Address - Street 1:9500 ANNAPOLIS RD STE B6
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2079
Practice Address - Country:US
Practice Address - Phone:240-394-8372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health