Provider Demographics
NPI:1235399791
Name:COMMUNITY COUNSELING SOLUTIONS, LLC
Entity Type:Organization
Organization Name:COMMUNITY COUNSELING SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TRIPHINIA
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LPC
Authorized Official - Phone:404-761-2446
Mailing Address - Street 1:2949 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-4152
Mailing Address - Country:US
Mailing Address - Phone:404-761-2446
Mailing Address - Fax:678-669-2651
Practice Address - Street 1:2949 PEARL ST
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-4152
Practice Address - Country:US
Practice Address - Phone:404-761-2446
Practice Address - Fax:678-669-2651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health