MEDICARE: CHRISTIAN COUNSELING CENTER OF BATTLE CREEK INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	6301007059	MI

General Provider Information

NPI Number	:	1114166907
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTIAN COUNSELING CENTER OF BATTLE CREEK INC

Provider Business Mailing Address
First Line	:	601 S SHORE DR UNIT 224
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49014-5440
Country	:	US
Telephone Number	:	269-979-8119
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 S SHORE DR UNIT 224
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49014-5440
Country	:	US
Telephone Number	:	269-979-8119
Fax Number	:	269-979-8124

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KIM READ
Credential	:	LPC
Telephone Number	:	269-979-8119

Provider Enumeration Date	:	02/18/2009
Last Update Date	:	08/21/2023

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