Provider Demographics
NPI:1841495090
Name:THE CHRISTIAN COUNSELING & WELLNESS GROUP, INC.
Entity type:Organization
Organization Name:THE CHRISTIAN COUNSELING & WELLNESS GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS
Authorized Official - Phone:336-273-8305
Mailing Address - Street 1:PO BOX 21034
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27420-1034
Mailing Address - Country:US
Mailing Address - Phone:336-273-8305
Mailing Address - Fax:336-273-8308
Practice Address - Street 1:1150 REVOLUTION MILL DR # 1
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5065
Practice Address - Country:US
Practice Address - Phone:336-273-8305
Practice Address - Fax:336-273-8308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health