Provider Demographics
NPI:1396114260
Name:COMMUNITY COUNSELING SOLUTIONS
Entity type:Organization
Organization Name:COMMUNITY COUNSELING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL BASED THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAJANE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRIX-MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:541-575-1466
Mailing Address - Street 1:528 E MAIN ST
Mailing Address - Street 2:SUITE W
Mailing Address - City:JOHN DAY
Mailing Address - State:OR
Mailing Address - Zip Code:97845-1289
Mailing Address - Country:US
Mailing Address - Phone:541-575-1466
Mailing Address - Fax:541-575-1411
Practice Address - Street 1:528 E MAIN ST
Practice Address - Street 2:SUITE W
Practice Address - City:JOHN DAY
Practice Address - State:OR
Practice Address - Zip Code:97845-1289
Practice Address - Country:US
Practice Address - Phone:541-575-1466
Practice Address - Fax:541-575-1411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)