Provider Demographics
NPI:1851953129
Name:CHRISTIAN COUNSELING AND FAMILY SERVICES
Entity Type:Organization
Organization Name:CHRISTIAN COUNSELING AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:618-242-4185
Mailing Address - Street 1:301 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IL
Mailing Address - Zip Code:62864-3544
Mailing Address - Country:US
Mailing Address - Phone:618-242-4185
Mailing Address - Fax:618-242-0818
Practice Address - Street 1:301 N 10TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-3544
Practice Address - Country:US
Practice Address - Phone:618-242-4185
Practice Address - Fax:618-242-0818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty