Provider Demographics
NPI:1841317450
Name:CENTER FOR COUNSELING & HUMAN DEVELOPMENT INC
Entity type:Organization
Organization Name:CENTER FOR COUNSELING & HUMAN DEVELOPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THERON
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:COVIN
Authorized Official - Suffix:
Authorized Official - Credentials:EBD
Authorized Official - Phone:336-774-7704
Mailing Address - Street 1:191 KATHERINE AVE
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36360
Mailing Address - Country:US
Mailing Address - Phone:334-774-7704
Mailing Address - Fax:334-774-7704
Practice Address - Street 1:191 KATHERINE AVE
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360
Practice Address - Country:US
Practice Address - Phone:334-774-7704
Practice Address - Fax:334-774-7704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty