Provider Demographics
NPI:1124542949
Name:CCCS & ASSOCIATES LLC
Entity Type:Organization
Organization Name:CCCS & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OUTPATIENT
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:WOERNER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-431-0105
Mailing Address - Street 1:708 S ROSEMONT RD STE 203
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-4061
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:708 S ROSEMONT RD STE 203
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-4061
Practice Address - Country:US
Practice Address - Phone:757-431-0105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-02
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty