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General NPI Number Information
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NPI Number | 1821352121
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Entity Type | Organization
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Legal Business Name | ART OF CREATIVE DIMENSIONS, INC., THE
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Dates
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Enumeration Date | 07/02/2012
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Last Update Date | 07/02/2012
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Provider Practice Location Address
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Address Line | 4 N HOWELL ST SUITE 260
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City | HILLSDALE
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State | MI
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Zip | 49242-1780
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Country | US
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Telephone | 517-315-1367
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Fax | 517-356-3267
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Provider Business Mailing Address
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Address Line | 4 N HOWELL ST SUITE 260
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City | HILLSDALE
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State | MI
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Zip | 49242-1780
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Country | US
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Telephone | 517-315-1367
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Fax | 517-356-3267
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MRS. KEILA KAE KILGORE
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Credential | LPC, CTC
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Telephone | 517-315-1367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401009781
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401009781
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | CC-XVW450025540
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401009781
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License Number State | MI
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