Provider Demographics
NPI:1972881274
Name:CHRISTIAN COUNSELING SERVICES
Entity Type:Organization
Organization Name:CHRISTIAN COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:GERBER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:765-289-1631
Mailing Address - Street 1:1804 N WHEELING AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-1678
Mailing Address - Country:US
Mailing Address - Phone:765-289-1631
Mailing Address - Fax:
Practice Address - Street 1:1804 N WHEELING AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-1678
Practice Address - Country:US
Practice Address - Phone:765-289-1631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty