Healthcare Provider Details

I. General information

NPI: 1740103597
Provider Name (Legal Business Name): CREED COUNSELING 109 PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 MULE DEER RD UNIT 1
AMARILLO TX
79124-3657
US

IV. Provider business mailing address

1301 MULE DEER RD
AMARILLO TX
79124-3637
US

V. Phone/Fax

Practice location:
  • Phone: 806-433-6315
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MARI L ALONZO
Title or Position: OWNER
Credential: LCSW
Phone: 806-200-6411