Provider Demographics
NPI:1245656362
Name:CREATING SCHOLARS THROUGH THERAPY, LLC
Entity type:Organization
Organization Name:CREATING SCHOLARS THROUGH THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:NABILA
Authorized Official - Middle Name:S
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-763-7144
Mailing Address - Street 1:PO BOX 7113
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-0113
Mailing Address - Country:US
Mailing Address - Phone:757-262-2040
Mailing Address - Fax:
Practice Address - Street 1:2013 CUNNINGHAM DR
Practice Address - Street 2:SUITE 100
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3306
Practice Address - Country:US
Practice Address - Phone:757-262-2040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2078251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health