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General NPI Number Information
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NPI Number | 1790620730
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Entity Type | Organization
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Legal Business Name | COMMUNITY COUNSELING INSTITUTE
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Dates
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Enumeration Date | 04/23/2026
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Last Update Date | 04/23/2026
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Provider Practice Location Address
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Address Line | 4427 6TH AVE
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City | TACOMA
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State | WA
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Zip | 98406-3631
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Country | US
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Telephone | 253-759-0852
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Fax | 253-752-0514
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Provider Business Mailing Address
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Address Line | CCI - P.O. BOX 5305
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City | TACOMA
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State | WA
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Zip | 98415-0305
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Country | US
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Telephone | 253-759-0852
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Fax | 253-752-0514
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Authorized Official
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Title or Position | AOR- BUSINESS MANAGER
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Name | BERNARD MINTER
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Credential |
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Telephone | 253-759-0852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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