Organization
CREATIVE COUNSELING AND CONSULTATION, PLLC
Active
Organization
CREATIVE COUNSELING AND CONSULTATION, PLLC
Active
Other names
Creative Counseling & Consultation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER LONGORIA LCSW (CO-OWNER)
(270) 872-3540
Entity
Organization
Contact information
Practice address
110 VILLAGE DR, ELIZABETHTOWN, KY 42701-2423
(270) 594-1199
Mailing address
1518 YORKSHIRE DR, ELIZABETHTOWN, KY 42701-9191
(270) 872-3540
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100819490
—
KY
Enumeration date
02/03/2022
Last updated
11/17/2023
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