Organization
LOUISA CREATIVE COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY BAZZANELLA LPC, RPT, CCTP (OWNER)
(540) 604-3267
Entity
Organization
Contact information
Practice address
421 MINERAL AVE # 192, MINERAL, VA 23117-4049
(540) 259-3646
(540) 259-3647
Mailing address
PO BOX 192, MINERAL, VA 23117-0192
(540) 604-3267
(844) 480-1755
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
0701006594
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
601101224
—
VA
Enumeration date
05/07/2016
Last updated
02/04/2022
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