Healthcare Provider Details

I. General information

NPI: 1699176537
Provider Name (Legal Business Name): CREATIVE COUNSELING SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2014
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 MALL BLVD BLDG B
SAVANNAH GA
31406-4862
US

IV. Provider business mailing address

5 SW BROAD ST
METTER GA
30439-4433
US

V. Phone/Fax

Practice location:
  • Phone: 912-515-5026
  • Fax:
Mailing address:
  • Phone: 912-515-5026
  • Fax: 912-785-2008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number005731
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number507450
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number507450
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY JAY STRICKLAND
Title or Position: OWNER-LEAD COUNSELOR
Credential: M.ED., LPC, MAC, CCS
Phone: 912-515-5026