Organization
CREATIVE COUNSELING SERVICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAMEKIA SHAQAWANA ALVIN (OWNER,CEO)
(919) 802-3704
Entity
Organization
Contact information
Practice address
104 INVESTORS WAY, CAMDEN, NC 27921-0000
(919) 802-3704
Mailing address
104 INVESTORS WAY, CAMDEN, NC 27921
(919) 802-3704
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366845174
INDIVIDUAL NPI
NC
Enumeration date
04/09/2015
Last updated
04/09/2015
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