Provider Demographics
NPI:1992160899
Name:CREATIVE COUNSELING CHOICES
Entity type:Organization
Organization Name:CREATIVE COUNSELING CHOICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAUBIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-457-2161
Mailing Address - Street 1:2092 S CUSTER RD
Mailing Address - Street 2:2092 S CUSTER RD
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-1831
Mailing Address - Country:US
Mailing Address - Phone:734-457-2161
Mailing Address - Fax:734-457-4146
Practice Address - Street 1:2092 S CUSTER RD
Practice Address - Street 2:2092 S CUSTER RD
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-1831
Practice Address - Country:US
Practice Address - Phone:734-457-2161
Practice Address - Fax:734-457-4146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-18
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801088306101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty