NPIMap

Organization Active NPI

Community Counseling Center Inc

  • Clinical Social Worker
  • Athens, TX
National Provider Identifier
1285946343
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S14353 Issued in TX
Legal business name
COMMUNITY COUNSELING CENTER INC
Practice address
702 S Palestine St
Athens, TX 75751-3325
Phone
(903) 675-9595
Fax
(903) 677-2110
NPI assigned
Jul 6, 2010
Last updated
Sep 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Bonny McBride, LCSWNPI 1972651560
Title
Owner
Phone
(903) 675-9595

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X S14353 TX Primary

Addresses

Primary practice location

702 S Palestine St
Athens, TX 75751-3325

Mailing address

PO Box 2536
Athens, TX 75751-7536
Phone (903) 675-9595

National Provider Directory

National Provider Directory

Locations

702 S Palestine St
Athens, TX 75751
Phone (903) 675-9595

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317081600000",
    "number": "1285946343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2536",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757517536",
            "telephone_number": "903-675-9595",
            "fax_number": "903-677-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 S PALESTINE ST",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757513325",
            "telephone_number": "903-675-9595",
            "fax_number": "903-677-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COUNSELING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-06",
        "last_updated": "2011-09-27",
        "status": "A",
        "authorized_official_last_name": "MCBRIDE",
        "authorized_official_first_name": "BONNY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-675-9595",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "S14353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.