Provider Demographics
NPI:1952563173
Name:CHRIST COMMUNITY CHURCH
Entity Type:Organization
Organization Name:CHRIST COMMUNITY CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:M
Authorized Official - Last Name:MURPHEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:815-879-3227
Mailing Address - Street 1:1719 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:IL
Mailing Address - Zip Code:61356-2636
Mailing Address - Country:US
Mailing Address - Phone:815-879-3227
Mailing Address - Fax:815-875-8780
Practice Address - Street 1:1719 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IL
Practice Address - Zip Code:61356-2636
Practice Address - Country:US
Practice Address - Phone:815-879-3227
Practice Address - Fax:815-875-8780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-29
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180001535101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty