Provider Demographics
NPI:1811248685
Name:CHRISTIAN COUNSELING CENTER OF WEST MONROE INC.
Entity type:Organization
Organization Name:CHRISTIAN COUNSELING CENTER OF WEST MONROE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRENTON
Authorized Official - Middle Name:D
Authorized Official - Last Name:LANGHOFER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:316-992-3062
Mailing Address - Street 1:3201 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-2229
Mailing Address - Country:US
Mailing Address - Phone:316-992-3062
Mailing Address - Fax:
Practice Address - Street 1:3201 N 7TH ST
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-2229
Practice Address - Country:US
Practice Address - Phone:316-992-3062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA40849756D251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health