Organization
CREATIVE COUNSELING GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYLER ALLEN CONNER MA, RMHCI (OWNER)
(407) 810-8319
Entity
Organization
Contact information
Practice address
1928 PROCTOR AVE, ORLANDO, FL 32817-4200
(407) 810-8319
Mailing address
1928 PROCTOR AVE, ORLANDO, FL 32817-4200
(407) 810-8319
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
IMH14125
FL
Other
Enumeration date
04/11/2017
Last updated
04/11/2017
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