Provider Demographics
NPI:1275700908
Name:CHRISTIAN COUNSELING CENTERS, INC.
Entity Type:Organization
Organization Name:CHRISTIAN COUNSELING CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:HARTLEY
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:650-570-7273
Mailing Address - Street 1:1510 FASHION ISLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94404-1596
Mailing Address - Country:US
Mailing Address - Phone:650-570-7273
Mailing Address - Fax:650-570-4283
Practice Address - Street 1:1510 FASHION ISLAND BLVD
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94404-1596
Practice Address - Country:US
Practice Address - Phone:650-570-7273
Practice Address - Fax:650-570-4283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health