Provider Demographics
NPI:1497818454
Name:CHRISTIAN COUNSELING MINISTRIES, INC.
Entity Type:Organization
Organization Name:CHRISTIAN COUNSELING MINISTRIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-498-3373
Mailing Address - Street 1:2150 MEMORIAL DR
Mailing Address - Street 2:SUITE #213
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54303-6335
Mailing Address - Country:US
Mailing Address - Phone:920-498-3383
Mailing Address - Fax:920-498-3705
Practice Address - Street 1:2150 MEMORIAL DR
Practice Address - Street 2:SUITE #213
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-6335
Practice Address - Country:US
Practice Address - Phone:920-498-3383
Practice Address - Fax:920-498-3705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health