Provider Demographics
NPI:1295029262
Name:COORDINATED COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:COORDINATED COUNSELING SERVICES, LLC
Other - Org Name:PRESENTSELF COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOTHERAPIST/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:RACHEL
Authorized Official - Last Name:XAVIER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CAGS, LMHC
Authorized Official - Phone:401-862-1877
Mailing Address - Street 1:221 KILVERT ST
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1343
Mailing Address - Country:US
Mailing Address - Phone:401-862-1877
Mailing Address - Fax:
Practice Address - Street 1:221 KILVERT ST
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1343
Practice Address - Country:US
Practice Address - Phone:401-328-5659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIMHC00375OtherSTATE LICENSE