Organization
CENTER FOR CREATIVE CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN S JAMES LPC (COUNSELOR/OWNER)
(573) 756-3330
Entity
Organization
Contact information
Practice address
506 NORTH ST, FARMINGTON, MO 63640-3213
(573) 756-3330
(573) 747-3023
Mailing address
PO BOX 506, FARMINGTON, MO 63640-0506
(573) 756-3330
(573) 747-3023
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001502
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
493642904
—
MO
Enumeration date
09/22/2009
Last updated
09/22/2009
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