Provider Demographics
NPI:1164977260
Name:CCARE COUNSELING LLC
Entity Type:Organization
Organization Name:CCARE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW/LISW-S
Authorized Official - Phone:513-773-4149
Mailing Address - Street 1:507 S COLLEGE AVE STE F
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-2211
Mailing Address - Country:US
Mailing Address - Phone:513-773-4149
Mailing Address - Fax:888-356-1203
Practice Address - Street 1:507 S COLLEGE AVE STE F
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-2211
Practice Address - Country:US
Practice Address - Phone:513-773-4149
Practice Address - Fax:888-356-1203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1200767-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty