| Lavelle Creative Llc | |
|
600 Guadalupe St Apt 3515 Austin TX 78701-3367 | |
| (512) 487-4303 | |
| Not Available |
| Full Name | Lavelle Creative Llc |
|---|---|
| Speciality | Case Management |
| Location | 600 Guadalupe St Apt 3515, Austin, Texas |
| Authorized Official Name and Position | Jeremy Wilson (OWNER) |
| Authorized Official Contact | 5124874303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lavelle Creative Llc 600 Guadalupe St Apt 3515 Austin TX 78701-3367 Ph: (512) 487-4303 | Lavelle Creative Llc 600 Guadalupe St Apt 3515 Austin TX 78701-3367 Ph: (512) 487-4303 |
| NPI Number | 1477397594 |
|---|---|
| Provider Enumeration Date | 06/24/2024 |
| Last Update Date | 06/24/2024 |
| Certification Date | 06/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477397594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
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