Provider Demographics
NPI:1699142026
Name:CREATIVE COUNSELING, LLC
Entity type:Organization
Organization Name:CREATIVE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:M ED, LPC, NCC
Authorized Official - Phone:318-245-3906
Mailing Address - Street 1:PO BOX 349
Mailing Address - Street 2:
Mailing Address - City:STONEWALL
Mailing Address - State:LA
Mailing Address - Zip Code:71078-0349
Mailing Address - Country:US
Mailing Address - Phone:318-221-2828
Mailing Address - Fax:318-221-2998
Practice Address - Street 1:7591 FERN AVE STE 1703
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5749
Practice Address - Country:US
Practice Address - Phone:318-221-2828
Practice Address - Fax:318-221-2998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-02
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4367251S00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health