Provider Demographics
NPI:1962656991
Name:CHRISTIAN FAMILY COUNSELING CENTER
Entity Type:Organization
Organization Name:CHRISTIAN FAMILY COUNSELING CENTER
Other - Org Name:DONA R. BENZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/CERTIFIED COUNSELOR SUPERV
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONA LOIS
Authorized Official - Middle Name:RAGSDALE
Authorized Official - Last Name:BENZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC-S, DAPA, CCF
Authorized Official - Phone:972-271-2989
Mailing Address - Street 1:3960 BROADWAY BLVD.
Mailing Address - Street 2:SUITE 220-C
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-2596
Mailing Address - Country:US
Mailing Address - Phone:972-271-2989
Mailing Address - Fax:972-271-9489
Practice Address - Street 1:3960 BROADWAY BLVD.
Practice Address - Street 2:SUITE 220-C
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-2596
Practice Address - Country:US
Practice Address - Phone:972-271-2989
Practice Address - Fax:972-271-9489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13638103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty