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General NPI Number Information
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NPI Number | 1639790629
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Entity Type | Organization
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Legal Business Name | CREATIVE CARE HEALING COUNSELING & CONSULTING
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Dates
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Enumeration Date | 04/30/2020
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Last Update Date | 04/30/2020
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Provider Practice Location Address
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Address Line | 410 EVERNIA ST APT 221
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-5433
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Country | US
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Telephone | 561-248-4831
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Fax |
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Provider Business Mailing Address
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Address Line | 410 EVERNIA ST APT 221
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-5433
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Country | US
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Telephone | 561-248-4831
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Fax |
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Authorized Official
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Title or Position | CEO/DIRECTOR
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Name | MS. MARIA M DIZ
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Credential | LMHC
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Telephone | 561-248-4831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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