Provider Demographics
NPI:1013996271
Name:CHURCHILL COUNSELING SERVICES, INC
Entity Type:Organization
Organization Name:CHURCHILL COUNSELING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMARGIO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPCC
Authorized Official - Phone:330-270-3040
Mailing Address - Street 1:P.O. BOX 3025
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44511-0025
Mailing Address - Country:US
Mailing Address - Phone:330-759-3040
Mailing Address - Fax:330-759-3070
Practice Address - Street 1:4531 BELMONT AVENUE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1041
Practice Address - Country:US
Practice Address - Phone:330-759-3040
Practice Address - Fax:330-759-3070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-15
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0811787Medicaid
OH2097878Medicaid
OH2503Medicare UPIN
OHCH9282562Medicare ID - Type UnspecifiedMEDICARE
OHCH9282561Medicare UPIN