Provider Demographics
NPI:1689050395
Name:CHRISTIAN COUNSELING EDUCATION ASSESSMENT & CONSULTING, INC.
Entity Type:Organization
Organization Name:CHRISTIAN COUNSELING EDUCATION ASSESSMENT & CONSULTING, INC.
Other - Org Name:CCEAC, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-239-8300
Mailing Address - Street 1:200 CAMPBELL DR
Mailing Address - Street 2:SUITE 105 E
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-1067
Mailing Address - Country:US
Mailing Address - Phone:609-239-8300
Mailing Address - Fax:609-239-8333
Practice Address - Street 1:200 CAMPBELL DR
Practice Address - Street 2:SUITE 105 E
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-1067
Practice Address - Country:US
Practice Address - Phone:609-239-8300
Practice Address - Fax:609-239-8333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00524100101YA0400X, 101YM0800X, 101YP1600X, 101YP2500X, 103TC0700X, 104100000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty