Organization
LOUISA CREATIVE COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY L BAZZANELLA M.A., LPC (OWNER)
(540) 604-3267
Entity
Organization
Contact information
Practice address
315 JOHNNY HALL RD, MINERAL, VA 23117-5202
(540) 604-3267
Mailing address
7036 ZACHARY TAYLOR HWY, MINERAL, VA 23117-5312
(540) 604-3267
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701006594
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
601101224
—
VA
Enumeration date
10/20/2016
Last updated
10/20/2016
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