Christian Counseling Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

17800785 Issued in IL

Legal business name

CHRISTIAN COUNSELING CENTER

Practice address

2804 S Park Ave
Herrin, IL 62948-3723

Phone

(618) 925-3714

Fax

(618) 988-2144

NPI assigned

Mar 2, 2015

Last updated

Mar 2, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Richard Gregory Hall, MSED, NCC, LPC, DCC

Title

President

Phone

(618) 925-3714

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425254400000",
    "number": "1376935122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 N 13TH ST",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629482843",
            "telephone_number": "618-925-3714",
            "fax_number": "618-988-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 S PARK AVE",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483723",
            "telephone_number": "618-925-3714",
            "fax_number": "618-988-2144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-02",
        "last_updated": "2015-03-02",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-925-3714",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSED, NCC, LPC, DCC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "17800785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tiffany Colborn, NP

• Community/Behavioral Health Agency in Herrin, IL
• Providers in Herrin, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; 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.