Organization
CREATIVE COUNSELING & WELLNESS CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SONYA RENEE OGLESBY PHD (CEO/ THERAPIST)
(336) 831-4051
Entity
Organization
Contact information
Practice address
163 STRATFORD CT, SUITE 170, WINSTON SALEM, NC 27103-1836
(336) 831-4051
(336) 436-9123
Mailing address
163 STRATFORD CT, SUITE 170, WINSTON SALEM, NC 27103-1836
(336) 831-4051
(336) 436-9123
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3028A
NC
101YM0800X
Mental Health Counselor
8040
NC
101YP2500X
Professional Counselor
8040
NC
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6115116
—
NC
Enumeration date
06/29/2009
Last updated
09/13/2022
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