# CREATIVE COUNSELING PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154382265
- **Authorized official:** MICHELLE ANN SALOMON LMHC (PRES)
- **Authorized official phone:** (407) 688-1770

## Contact information

- **Practice address:** 205 WAYMONT CT, SUITE 111, LAKE MARY, FL 32746-3593
- **Practice address phone:** (407) 688-1770
- **Practice address fax:** (407) 688-7205
- **Mailing address:** 205 WAYMONT COURT, SUITE 111, LAKE MARY, FL 32746-3549
- **Mailing address phone:** (407) 688-1770
- **Mailing address fax:** (407) 688-7205

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | MH7317 | FL | Yes |

## Other

- **Enumeration date:** 03/29/2006
- **Last updated:** 11/09/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | Z034U | BLUE CROSS BLUE SHIELD | FL |