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General NPI Number Information
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NPI Number | 1073078564
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Entity Type | Organization
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Legal Business Name | COMMUNITY COUNSELING SERVICES
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Dates
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Enumeration Date | 02/08/2019
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 219 WOOD ST
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City | WEST POINT
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State | MS
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Zip | 39773-3293
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Country | US
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Telephone | 662-494-4066
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Fax | 662-524-4364
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Provider Business Mailing Address
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Address Line | 302 N JACKSON ST
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City | STARKVILLE
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State | MS
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Zip | 39759-2504
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Country | US
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Telephone | 662-323-9318
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Fax | 662-323-5553
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Authorized Official
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Title or Position | BILLING SUPERVISOR
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Name | KATHY DOSS
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Credential |
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Telephone | 662-323-9318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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