Provider Demographics
NPI:1194891275
Name:CHRISTIAN COUNSELING CENTER
Entity type:Organization
Organization Name:CHRISTIAN COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:BILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-935-3839
Mailing Address - Street 1:1060 W. BUSCH BLVD
Mailing Address - Street 2:STE 104
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7707
Mailing Address - Country:US
Mailing Address - Phone:813-935-3917
Mailing Address - Fax:813-985-5840
Practice Address - Street 1:1060 W. BUSCH BLVD
Practice Address - Street 2:STE 104
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7707
Practice Address - Country:US
Practice Address - Phone:813-935-3917
Practice Address - Fax:813-935-5840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty