Community Clinic Center, LTD

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

COMMUNITY CLINIC CENTER, LTD

Practice address

666 Russel CT
Suite 105
Woodstock, IL 60098-2670

Phone

(815) 338-7749

Fax

(815) 338-7728

NPI assigned

Dec 19, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert L Meyer, PHD

Title

Licensed Clinical Psychologist

Phone

(815) 338-7749

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1881878494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "666 RUSSEL CT",
            "address_2": "SUITE 105",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600982670",
            "telephone_number": "815-338-7749",
            "fax_number": "815-338-7728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 RUSSEL CT",
            "address_2": "SUITE 105",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600982670",
            "telephone_number": "815-338-7749",
            "fax_number": "815-338-7728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CLINIC CENTER, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "815-338-7749",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ericka Christiansen, LCSW
• Dawn Maureen Tan Clam, PT
• Sarah Elizabeth Clark, LPC
• Phetsavanh Coggin, LCPC
• Community Chiropractic Center Woodstock SC
• Community Counseling Center, LTD.
• Community Health Partnership of Illinois
• Timothy D Conway, DDS
• Richard O Cook, MD
• Evone Kay Coombs, MA, LCPC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Woodstock, IL
• Providers in Woodstock, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.