# GC CREATIVE COUNSELING, PLLC

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

## Provider details

- **NPI number:** 1922991447
- **Authorized official:** JENNIFER DIANNE CONRAD LCMHCA, NCC (OWNER/THERAPIST)
- **Authorized official phone:** (919) 480-8124

## Contact information

- **Practice address:** 407 N SUMNER ST, SELMA, NC 27576-2530
- **Practice address phone:** (919) 480-8124
- **Mailing address:** 407 N SUMNER ST, SELMA, NC 27576-2530
- **Mailing address phone:** (919) 480-8124

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/02/2025
- **Last updated:** 06/02/2025