Provider Demographics
NPI:1295946051
Name:COUNSELORS AND CREATIVE CONSULTANTS, INC.
Entity type:Organization
Organization Name:COUNSELORS AND CREATIVE CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT MENTAL HEALTHTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERI
Authorized Official - Middle Name:YEVETTE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:313-673-3336
Mailing Address - Street 1:615 GRISWOLD ST
Mailing Address - Street 2:SUITE 532
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48226-3900
Mailing Address - Country:US
Mailing Address - Phone:313-673-3336
Mailing Address - Fax:248-661-1786
Practice Address - Street 1:615 GRISWOLD ST
Practice Address - Street 2:SUITE 532
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-3900
Practice Address - Country:US
Practice Address - Phone:313-673-3336
Practice Address - Fax:248-661-1786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)