Provider Demographics
NPI:1487394763
Name:CREATIVE HEALING COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:CREATIVE HEALING COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERITA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:662-319-1876
Mailing Address - Street 1:530 HIGHWAY 145 N STE A
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MS
Mailing Address - Zip Code:39730-2156
Mailing Address - Country:US
Mailing Address - Phone:662-319-1876
Mailing Address - Fax:662-369-1739
Practice Address - Street 1:530 HIGHWAY 145 N STE A
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MS
Practice Address - Zip Code:39730-2156
Practice Address - Country:US
Practice Address - Phone:662-319-1876
Practice Address - Fax:662-369-1739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-01
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty