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General NPI Number Information
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NPI Number | 1346600020
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Entity Type | Organization
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Legal Business Name | COUNSELING CENTERS INTERNATIONAL
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Dates
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Enumeration Date | 02/24/2016
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Last Update Date | 10/28/2016
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Provider Practice Location Address
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Address Line | 908 PAREDES LINE RD.
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City | BROWNSVILLE
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State | TX
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Zip | 78521-2660
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Country | US
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Telephone | 956-423-1194
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Fax |
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Provider Business Mailing Address
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Address Line | 33082 FM 1575
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City | LOS FRESNOS
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State | TX
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Zip | 78566-4169
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Country | US
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Telephone | 512-716-9245
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | MRS. LEAH ANN ELLIS
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Credential | M.ED., LPC
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Telephone | 512-716-9245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 20201
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License Number State | TX
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