Provider Demographics
NPI:1740482587
Name:COMMUNITY COUNSELING CENTER
Entity type:Organization
Organization Name:COMMUNITY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COUNSELING SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:C
Authorized Official - Last Name:FROTHINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:662-332-1819
Mailing Address - Street 1:850 MCALLISTER ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38701-5805
Mailing Address - Country:US
Mailing Address - Phone:662-332-1819
Mailing Address - Fax:662-332-8790
Practice Address - Street 1:850 MCALLISTER ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38701-5805
Practice Address - Country:US
Practice Address - Phone:662-332-1819
Practice Address - Fax:662-332-8790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0350101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty