| Center For Creative Change | |
|
506 North St Farmington MO 63640-3213 | |
| (573) 756-3330 | |
| (573) 747-3023 |
| Full Name | Center For Creative Change |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 506 North St, Farmington, Missouri |
| Authorized Official Name and Position | Lynn S James (COUNSELOR/OWNER) |
| Authorized Official Contact | 5737563330 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Creative Change Po Box 506 Farmington MO 63640-0506 Ph: (573) 756-3330 | Center For Creative Change 506 North St Farmington MO 63640-3213 Ph: (573) 756-3330 |
| NPI Number | 1619201746 |
|---|---|
| Provider Enumeration Date | 09/22/2009 |
| Last Update Date | 09/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619201746 | NPI | - | NPPES |
| 493642904 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 001502 (Missouri) | Primary |
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