Provider Demographics
NPI:1053907014
Name:CREATING CONNECTIONS
Entity type:Organization
Organization Name:CREATING CONNECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MERRILIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RACKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:856-371-4333
Mailing Address - Street 1:13054 CHAPEL HILL LN
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35613-8488
Mailing Address - Country:US
Mailing Address - Phone:856-371-4333
Mailing Address - Fax:
Practice Address - Street 1:13054 CHAPEL HILL LN
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35613-8488
Practice Address - Country:US
Practice Address - Phone:856-371-4333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty