Provider Demographics
NPI:1528610573
Name:CREATIVE COUNSELING CONSULTANTS, LLC.
Entity type:Organization
Organization Name:CREATIVE COUNSELING CONSULTANTS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GILSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:810-293-5063
Mailing Address - Street 1:5343 BIRCHTREE CT
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3301
Mailing Address - Country:US
Mailing Address - Phone:810-293-5063
Mailing Address - Fax:
Practice Address - Street 1:5343 BIRCHTREE CT
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3301
Practice Address - Country:US
Practice Address - Phone:810-293-5063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty