Provider Demographics
NPI:1710181920
Name:CHRISTIAN COUNSELING CENTER INC
Entity Type:Organization
Organization Name:CHRISTIAN COUNSELING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:336-227-5476
Mailing Address - Street 1:142 S LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5823
Mailing Address - Country:US
Mailing Address - Phone:336-227-5476
Mailing Address - Fax:336-437-1898
Practice Address - Street 1:142 S LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5823
Practice Address - Country:US
Practice Address - Phone:336-227-5476
Practice Address - Fax:336-437-1898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0297VOtherBCBS
NC1637Medicare PIN