Provider Demographics
NPI:1902336365
Name:INSPIRED CREATIVE SOLUTIONS THERAPY, LLC
Entity Type:Organization
Organization Name:INSPIRED CREATIVE SOLUTIONS THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSLEOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LATRICE
Authorized Official - Middle Name:LANETTE
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:318-537-4397
Mailing Address - Street 1:240 LENOX BRG
Mailing Address - Street 2:
Mailing Address - City:STERLINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:71280-3346
Mailing Address - Country:US
Mailing Address - Phone:318-537-4397
Mailing Address - Fax:318-325-8749
Practice Address - Street 1:908 N 3RD ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5844
Practice Address - Country:US
Practice Address - Phone:318-537-4397
Practice Address - Fax:318-325-8749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-18
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5828101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty