Healthcare Provider Details

I. General information

NPI: 1255246005
Provider Name (Legal Business Name): COMMUNITY COUNSELING SOLUTIONS DBA STAR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 TURNER CT NE
BOARDMAN OR
97818
US

IV. Provider business mailing address

PO BOX 469
HEPPNER OR
97836-0469
US

V. Phone/Fax

Practice location:
  • Phone: 541-436-8145
  • Fax:
Mailing address:
  • Phone: 541-676-9161
  • Fax: 541-676-5662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: STEFANIE JOELLE SWEENEY
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 541-676-9161