Provider Demographics
NPI:1427428309
Name:CREATIVE COUNSELING AND LEARNING SOLUTIONS, PLLC
Entity type:Organization
Organization Name:CREATIVE COUNSELING AND LEARNING SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GREENHALGH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:704-422-5964
Mailing Address - Street 1:44381 NC 740 HWY
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:NC
Mailing Address - Zip Code:28127-9618
Mailing Address - Country:US
Mailing Address - Phone:704-422-5964
Mailing Address - Fax:704-422-5041
Practice Address - Street 1:250 N 3RD ST
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-4012
Practice Address - Country:US
Practice Address - Phone:704-961-3200
Practice Address - Fax:704-961-3299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7373251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health