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General NPI Number Information
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NPI Number | 1881507002
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Entity Type | Organization
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Legal Business Name | CREATING CONNECTION, PLC
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 191 KINNEY RD
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City | APPOMATTOX
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State | VA
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Zip | 24522-5594
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Country | US
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Telephone | 651-468-4326
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Fax |
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Provider Business Mailing Address
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Address Line | 191 KINNEY RD
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City | APPOMATTOX
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State | VA
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Zip | 24522-5594
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Country | US
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Telephone | 651-468-4326
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JORDAN LEE JOHNSON
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Credential | LPC
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Telephone | 651-468-4326
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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 | NULL
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