Provider Demographics
NPI:1598162166
Name:COUNSELING CENTERS INTERNATIONAL
Entity Type:Organization
Organization Name:COUNSELING CENTERS INTERNATIONAL
Other - Org Name:C.C.I. THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:956-423-1194
Mailing Address - Street 1:908 PAREDES LINE RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-2660
Mailing Address - Country:US
Mailing Address - Phone:956-423-1194
Mailing Address - Fax:866-394-0482
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:866-394-0482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-26
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65943101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX217622401Medicaid
TX217622402Medicaid