Provider Demographics
NPI:1366440737
Name:HILL COUNTRY CHRISTIAN COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:HILL COUNTRY CHRISTIAN COUNSELING CENTER, INC.
Other - Org Name:NEW HOPE COUNSLEING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FUDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DIRECTOR
Authorized Official - Phone:830-257-3009
Mailing Address - Street 1:1127 MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-3581
Mailing Address - Country:US
Mailing Address - Phone:830-257-3009
Mailing Address - Fax:830-257-3061
Practice Address - Street 1:1127 MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-3581
Practice Address - Country:US
Practice Address - Phone:830-257-3009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18662101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0037GTOtherBLUE CROSS BLUE SHIELD
TX171632601Medicaid
TX7636153OtherAETNA