Christian Counseling Center-San Jose

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CHRISTIAN COUNSELING CENTER-SAN JOSE

Practice address

3880 S Bascom Ave Ste 202
San Jose, CA 95124-2675

Phone

(408) 559-1115

Fax

(408) 371-9193

NPI assigned

Sep 14, 2020

Organization subpart

No

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

Authorized official

Name

Tina Engel, LMFT

Title

Executive Director

Phone

(408) 559-1115

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600041600000",
    "number": "1669087912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 S BASCOM AVE STE 202",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242675",
            "telephone_number": "408-559-1115",
            "fax_number": "408-371-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 S BASCOM AVE STE 202",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242675",
            "telephone_number": "408-559-1115",
            "fax_number": "408-371-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN COUNSELING CENTER-SAN JOSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A",
        "authorized_official_last_name": "ENGEL",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "408-559-1115",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in San Jose, CA
• Providers in San Jose, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.