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General NPI Number Information
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NPI Number | 1437210960
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Entity Type | Organization
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Legal Business Name | COLLEGE HEIGHTS CHRISTIAN COUNSELING
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 811 SYCAMORE RD
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City | JOPLIN
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State | MO
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Zip | 64801-9586
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Country | US
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Telephone | 417-624-0570
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Fax | 417-624-0996
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Provider Business Mailing Address
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Address Line | 811 SYCAMORE RD
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City | JOPLIN
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State | MO
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Zip | 64801-9586
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Country | US
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Telephone | 417-624-0570
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Fax | 417-624-0996
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Authorized Official
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Title or Position | ACCOUNTS MANAGER
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Name | MR. JOHN ROBERT GILES
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Credential |
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Telephone | 417-624-0570
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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 |
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License Number State |
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