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General NPI Number Information
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NPI Number | 1710695648
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Entity Type | Organization
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Legal Business Name | CREATIVE COUNSELING 4 KIDS LLC
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Dates
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Enumeration Date | 11/09/2022
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 9804 MANCHESTER RD STE B
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City | SAINT LOUIS
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State | MO
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Zip | 63119-1210
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Country | US
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Telephone | 314-706-1562
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Fax | 636-333-4510
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Provider Business Mailing Address
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Address Line | 396 N BERRY RD
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City | SAINT LOUIS
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State | MO
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Zip | 63122-4735
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Country | US
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Telephone | 314-706-1562
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Fax | 636-333-4510
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Authorized Official
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Title or Position | OWNER, LCSW
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Name | YVETTE KRISTINE PELIKAN
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Credential | LCSW
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Telephone | 314-706-1562
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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