Provider Demographics
NPI:1508908658
Name:PASTORAL CARE AND COUNSELING INSTITUTE
Entity Type:Organization
Organization Name:PASTORAL CARE AND COUNSELING INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:K
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:D MIN
Authorized Official - Phone:919-489-6452
Mailing Address - Street 1:3325 DURHAM CHAPEL HILL BLVD
Mailing Address - Street 2:SUITE 220 CEDAR TERRACE OFFICES
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6235
Mailing Address - Country:US
Mailing Address - Phone:919-489-6452
Mailing Address - Fax:
Practice Address - Street 1:3325 DURHAM CHAPEL HILL BLVD
Practice Address - Street 2:SUITE 220 CEDAR TERRACE OFFICES
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6235
Practice Address - Country:US
Practice Address - Phone:919-489-6452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty