NPIMap

Organization Active NPI

Covenant Counseling Center

Doing business as six rivers counseling

  • Community/Behavioral Health Agency
  • Eureka, CA
National Provider Identifier
1497923312
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
125001555 Issued in CA
Legal business name
COVENANT COUNSELING CENTER
Doing business as
six rivers counseling
Practice address
3960 Walnut Drive
Eureka, CA 95503
Phone
(707) 268-8722
Fax
(707) 268-0218
NPI assigned
Feb 13, 2008
Last updated
Feb 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Authorized official

Name
Mr. John W Tillery, CPA
Title
Executive Director
Phone
(530) 245-5805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 125001555 CA Primary

Addresses

Primary practice location

3960 Walnut Drive
Eureka, CA 95503

Mailing address

393 Park Marina Circle
Redding, CA 96001
Phone (530) 245-5805

Other names 1

  • six rivers counseling Doing business as

National Provider Directory

National Provider Directory

Locations

393 Park Marina Cir
Redding, CA 96001

Practitioners & affiliated clinicians

Practitioners 199

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 199

NPI Registry JSON

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1497923312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 PARK MARINA CIRCLE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "96001",
            "telephone_number": "530-245-5805",
            "fax_number": "530-245-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 WALNUT DRIVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "95503",
            "telephone_number": "707-268-8722",
            "fax_number": "707-268-0218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "TILLERY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "530-245-5805",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "125001555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "six rivers counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; 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.