1326050568 NPI number — CHRISTIAN COUNSELING SERVICES INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326050568 NPI number — CHRISTIAN COUNSELING SERVICES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHRISTIAN COUNSELING SERVICES INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326050568
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17006 NE 33RD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VANCOUVER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98682-3640
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-608-1541
Provider Business Mailing Address Fax Number:
360-838-0235

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9407 NE VANCOUVER MALL DR STE 208
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98662-6191
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-882-2771
Provider Business Practice Location Address Fax Number:
360-838-0235
Provider Enumeration Date:
08/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ROWEN
Authorized Official First Name:
MICHELLE
Authorized Official Middle Name:
DIANE
Authorized Official Title or Position:
PRESIDENT/OWNER/COUSELOR
Authorized Official Telephone Number:
360-882-2771

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LMHC , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com