| Organization Name: | COMMUNITY COUNSELING CENTER OF MADISON, WI, INC. |
| NPI Number: | 1003936899 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHARON A BARGER (DIRECTOR) |
| Mailing Address: | 6629 University Ave Suite 209 Middleton |
| State: | WI US |
| Postal Code: | 535623037 |
| Phone Number: | 6088335880 |
| Fax Number: | 6088293787 |
| NPI Enumeration Date: | 03/29/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 1222 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |