Provider Demographics
NPI:1073902359
Name:CHRISTIAN COUNSELING AND CONSULTING, LLC
Entity Type:Organization
Organization Name:CHRISTIAN COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,
Authorized Official - Phone:901-207-6507
Mailing Address - Street 1:1120 SUMMER SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-9403
Mailing Address - Country:US
Mailing Address - Phone:901-207-6507
Mailing Address - Fax:901-850-5725
Practice Address - Street 1:1331 UNION AVE
Practice Address - Street 2:SUITE 707
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3513
Practice Address - Country:US
Practice Address - Phone:901-207-6507
Practice Address - Fax:901-850-5725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty