Organization
CREATIVE COUNSELING PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE ANN SALOMON LMHC (PRES)
(407) 688-1770
Entity
Organization
Contact information
Practice address
205 WAYMONT CT, SUITE 111, LAKE MARY, FL 32746-3593
(407) 688-1770
(407) 688-7205
Mailing address
205 WAYMONT COURT, SUITE 111, LAKE MARY, FL 32746-3549
(407) 688-1770
(407) 688-7205
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
MH7317
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z034U
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/29/2006
Last updated
11/09/2009
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