Provider Demographics
NPI:1912447681
Name:CCNT INC.
Entity Type:Organization
Organization Name:CCNT INC.
Other - Org Name:COUNSELING CENTER OF NORTH TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:469-342-3468
Mailing Address - Street 1:303 S HIGHWAY 78
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-3944
Mailing Address - Country:US
Mailing Address - Phone:469-342-3468
Mailing Address - Fax:469-342-3466
Practice Address - Street 1:303 S HIGHWAY 78
Practice Address - Street 2:SUITE 100
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-3944
Practice Address - Country:US
Practice Address - Phone:469-342-3468
Practice Address - Fax:469-342-3466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
TX503581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty