Organization
CREATIVE COUNSELING SOLUTIONS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT EDWARD KONKEL LICSW (PRESIDENT)
(508) 717-0212
Entity
Organization
Contact information
Practice address
345 UNION ST, NEW BEDFORD, MA 02740-3679
(508) 717-0212
(508) 717-0212
Mailing address
345 UNION ST, NEW BEDFORD, MA 02740-3679
(508) 717-0212
(508) 717-0212
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1022691
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013485440-0
PACIFICARE
MA
05
—
1853937
—
MA
01
—
6254470
UBHC
—
01
—
P06582
BC/BS
—
Enumeration date
04/23/2009
Last updated
06/16/2015
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