NPIMap

Organization Active NPI

Community Counseling Centers, Inc

  • Developmentally Disabled Services Day Training Agency
  • Winslow, AZ
National Provider Identifier
1699064188
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
COMMUNITY COUNSELING CENTERS, INC
Practice address
1008 E First St
Winslow, AZ 86047-4104
Phone
(928) 289-3383
Fax
(928) 289-3385
NPI assigned
Apr 5, 2011
Last updated
Apr 5, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Authorized official

Name
Beth Carlson
Title
Program Manager
Phone
(928) 289-3383

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary
Child Mental Illness Respite Care 385HR2055X
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X

Addresses

Primary practice location

1008 E First St
Winslow, AZ 86047-4104

Mailing address

1008 E First St
Winslow, AZ 86047-4104
Phone (928) 289-3383

Other identifiers 1

IdentifierTypeStateIssuer
108490MedicaidAZ

Other names 1

  • Winslow Developmental Disabilities Other name

National Provider Directory

National Provider Directory
Tax ID family
Community Counseling Ce8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1008 E First St
Winslow, AZ 86047
Phone (928) 289-3383

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301961600000",
    "number": "1699064188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 E FIRST ST",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "860474104",
            "telephone_number": "928-289-3383",
            "fax_number": "928-289-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 E FIRST ST",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "860474104",
            "telephone_number": "928-289-3383",
            "fax_number": "928-289-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COUNSELING CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-05",
        "last_updated": "2011-04-05",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "928-289-3383"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108490",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Winslow Developmental Disabilities",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Winslow, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.