Provider Demographics
NPI:1346600020
Name:COUNSELING CENTERS INTERNATIONAL
Entity Type:Organization
Organization Name:COUNSELING CENTERS INTERNATIONAL
Other - Org Name:COUNSELING CENTERS INTERNATIONAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC
Authorized Official - Phone:512-716-9245
Mailing Address - Street 1:33082 FM 1575
Mailing Address - Street 2:
Mailing Address - City:LOS FRESNOS
Mailing Address - State:TX
Mailing Address - Zip Code:78566-4169
Mailing Address - Country:US
Mailing Address - Phone:512-716-9245
Mailing Address - Fax:
Practice Address - Street 1:908 PAREDES LINE RD.
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-2660
Practice Address - Country:US
Practice Address - Phone:956-423-1194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20201101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty