Provider Demographics
NPI:1699262105
Name:CREATIVE FAMILY SOLUTIONS, INC.
Entity type:Organization
Organization Name:CREATIVE FAMILY SOLUTIONS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNCH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:941-592-8826
Mailing Address - Street 1:4418 TWEEDSMUIR CT
Mailing Address - Street 2:
Mailing Address - City:MOSELEY
Mailing Address - State:VA
Mailing Address - Zip Code:23120-1284
Mailing Address - Country:US
Mailing Address - Phone:941-592-8826
Mailing Address - Fax:888-393-8753
Practice Address - Street 1:13817 VILLAGE MILL DR STE H
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-4378
Practice Address - Country:US
Practice Address - Phone:941-592-8826
Practice Address - Fax:888-393-8753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-19
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1003163841OtherNPI