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NPI Code Detail

MEDICARE: COMMUNITY COUNSELING CENTER

MEDICARE: COMMUNITY COUNSELING CENTER
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)290-7523MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235244757
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY COUNSELING CENTER
Provider Business Mailing Address
First Line : 402 S SILVER SPRINGS RD
Second Line :
City : CAPE GIRARDEAU
State : MO
Zip : 63703-7536
Country : US
Telephone Number : 573-334-1100
Fax Number : 573-334-5531
Provider Business Practice Location Address
First Line : 402 S SILVER SPRINGS RD
Second Line :
City : CAPE GIRARDEAU
State : MO
Zip : 63703-7536
Country : US
Telephone Number : 573-334-1100
Fax Number : 573-334-5531
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : MRS. LISA TOLBERT
Credential :
Telephone Number : 573-334-1100
Provider Enumeration Date : 08/21/2006
Last Update Date : 09/17/2024

Similar Medicare Providers

1003620881 — JAMIE FILISAH RHYNE LPC
Practice Location Address:
402 S SILVER SPRINGS RD
CAPE GIRARDEAU, MO
63703-7536
Practice Phone: 573-334-1100
Practice Fax:
1124072350 — MRS. DANIELA A KANTCHEVA RN,MSN,APRN,BC
Practice Location Address:
402 S SILVER SPRINGS RD
CAPE GIRARDEAU, MO
63703-7536
Practice Phone: 573-334-1100
Practice Fax:
1568573038 — DR. KISHORE A KHOT M.D.
Practice Location Address:
402 S SILVER SPRINGS RD
CAPE GIRARDEAU, MO
63703-7536
Practice Phone: 573-334-1100
Practice Fax: 573-651-4345
1598876013 — DR. ROBERT E MCCOOL M.D.
Practice Location Address:
402 S SILVER SPRINGS RD
CAPE GIRARDEAU, MO
63703-7536
Practice Phone: 573-334-1100
Practice Fax: 573-334-8819
1144331687 — DR. REETA ROHATGI M.D.
Practice Location Address:
402 S SILVER SPRINGS RD
CAPE GIRARDEAU, MO
63703-7536
Practice Phone: 573-334-1100
Practice Fax: 573-651-4345
1538263025 — TOMMY D MCKINNEY LPC
Practice Location Address:
402 S SILVER SPRINGS RD
CAPE GIRARDEAU, MO
63703-7536
Practice Phone: 573-334-1100
Practice Fax: 573-651-4345

Directions to “COMMUNITY COUNSELING CENTER ” Practice Location

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