Healthcare Provider Details

I. General information

NPI: 1023923687
Provider Name (Legal Business Name): COMMUNITY RECOVERY COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 BROADWAY ST STE 202
CHICO CA
95928-5355
US

IV. Provider business mailing address

341 BROADWAY ST STE 202
CHICO CA
95928-5355
US

V. Phone/Fax

Practice location:
  • Phone: 530-720-6813
  • Fax:
Mailing address:
  • Phone: 530-720-6813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: LISA MARIE HEDEMARK
Title or Position: SUD COUNSELOR
Credential:
Phone: 530-720-6813