Organization
CRISARA CREATIVE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AVA JEAN WILLIAMS MS, BCPC (CEO/DIRECTOR OF COUNSELING)
(916) 422-8862
Entity
Organization
Contact information
Practice address
7000 FRANKLIN BOULEVARD, SUITE 350, SACRAMENTO, CA 95823-1839
(916) 422-8862
(916) 422-2050
Mailing address
PO BOX 581748, ELK GROVE, CA 95758-0030
(916) 422-8862
(916) 422-2050
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
CA
251S00000X
Community/Behavioral Health Agency
Primary
9555
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31474
DEPT OF TRANSPORTATION
CA
01
—
6DN00022
CPUC
CA
01
—
V797P-7015A
FEDERAL GSA/FSS
CA
01
—
ZZZ67877Z
BLUE SHIELD/BLUE CROSS
CA
Enumeration date
07/19/2006
Last updated
02/27/2008
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