Healthcare Provider Details

I. General information

NPI: 1437088572
Provider Name (Legal Business Name): CREATIVE COUNSELING VENTURES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 JEFFERSON ST STE 115
NEWNAN GA
30263-1949
US

IV. Provider business mailing address

41 JEFFERSON ST STE 115
NEWNAN GA
30263-1949
US

V. Phone/Fax

Practice location:
  • Phone: 404-422-4034
  • Fax: 770-426-8331
Mailing address:
  • Phone: 404-422-4034
  • Fax: 770-462-8331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ALLISON BUCHANAN
Title or Position: OWNER
Credential: LPC
Phone: 404-422-4034