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General NPI Number Information
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NPI Number | 1952519332
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Entity Type | Organization
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Legal Business Name | CHAMPIONS CHRISTIAN COUNSELING CENTER L.L.C
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 10/17/2011
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Provider Practice Location Address
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Address Line | 333 S CHERRY ST
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City | TOMBALL
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State | TX
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Zip | 77375-6614
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Country | US
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Telephone | 281-357-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 333 S CHERRY ST
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City | TOMBALL
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State | TX
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Zip | 77375-6614
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Country | US
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Telephone | 281-357-4111
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Fax |
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Authorized Official
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Title or Position | MINISTRY DIRECTOR & COUNSELOR
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Name | PAULA H. WHITAKER
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Credential | M.ED., MA, PCC, LPCI
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Telephone | 281-357-4111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 59667
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License Number State | TX
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