Provider Demographics
NPI:1457537425
Name:CHRISTIAN COUNSELING MINISTRIES, INC
Entity Type:Organization
Organization Name:CHRISTIAN COUNSELING MINISTRIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BERTHA
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:CHRISTIAN COUNSELOR
Authorized Official - Phone:803-348-1106
Mailing Address - Street 1:211 E BOUNDARY ST
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-8386
Mailing Address - Country:US
Mailing Address - Phone:803-348-1106
Mailing Address - Fax:803-345-0112
Practice Address - Street 1:211 E BOUNDARY ST
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-8386
Practice Address - Country:US
Practice Address - Phone:803-348-1106
Practice Address - Fax:803-345-0112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCORDAINED MINISTER101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty