Provider Demographics
NPI:1962736900
Name:CREATIVE SOUL-UTIONS COUNSELING
Entity type:Organization
Organization Name:CREATIVE SOUL-UTIONS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:H
Authorized Official - Last Name:KROTO
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:216-701-0371
Mailing Address - Street 1:21851 CENTER RIDGE RD STE 411
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3901
Mailing Address - Country:US
Mailing Address - Phone:216-701-0371
Mailing Address - Fax:216-261-1655
Practice Address - Street 1:21851 CENTER RIDGE RD STE 411
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3901
Practice Address - Country:US
Practice Address - Phone:216-701-0371
Practice Address - Fax:216-261-1655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.00071401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty