Organization
CENTER FOR CREATIVE LIVING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYSSA ANNE WINGFIELD (OFFICE MANGER)
(248) 414-4050
Entity
Organization
Contact information
Practice address
2011 CROOKS RD, ROYAL OAK, MI 48073-4049
(248) 414-4050
(248) 414-4053
Mailing address
2011 CROOKS RD, ROYAL OAK, MI 48073-4049
(248) 414-4050
(248) 414-4053
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
MI
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
03/30/2009
Last updated
03/30/2009
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