Provider Demographics
NPI:1740645050
Name:CC COUNSELING, LLC
Entity type:Organization
Organization Name:CC COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEHADE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:786-371-5128
Mailing Address - Street 1:1931 NW 150TH AVE
Mailing Address - Street 2:129
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2877
Mailing Address - Country:US
Mailing Address - Phone:786-371-5128
Mailing Address - Fax:
Practice Address - Street 1:1931 NW 150TH AVE
Practice Address - Street 2:129
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-2877
Practice Address - Country:US
Practice Address - Phone:786-371-5128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW11465103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1194954321Other1194954321