| Louisa Creative Counseling, Llc | |
|
421 Mineral Ave # 192 Mineral VA 23117-4049 | |
| (540) 259-3646 | |
| (540) 259-3647 |
| Full Name | Louisa Creative Counseling, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 421 Mineral Ave # 192, Mineral, Virginia |
| Authorized Official Name and Position | Kristy Bazzanella (OWNER) |
| Authorized Official Contact | 5406043267 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louisa Creative Counseling, Llc Po Box 192 Mineral VA 23117-0192 Ph: (540) 604-3267 | Louisa Creative Counseling, Llc 421 Mineral Ave # 192 Mineral VA 23117-4049 Ph: (540) 259-3646 |
| NPI Number | 1225484348 |
|---|---|
| Provider Enumeration Date | 05/07/2016 |
| Last Update Date | 02/04/2022 |
| Certification Date | 02/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225484348 | NPI | - | NPPES |
| 601101224 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | 0701006594 (Virginia) | Secondary |
Louisa Creative Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 Johnny Hall Rd, Mineral, VA 23117 Phone: 540-604-3267 |