| Organization Name: | CHRISTIAN COUNSELING CENTER AT FIRST LUTHERAN CHURCH |
| NPI Number: | 1073788618 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JENNIFER KAY DAMM (DIRECTOR/PRO CLINICAL COUNSELOR) |
| Mailing Address: | 300 Melmore St Tiffin |
| State: | OH US |
| Postal Code: | 448833535 |
| Phone Number: | 4194478111 |
| Fax Number: | 4194478158 |
| NPI Enumeration Date: | 04/24/2008 |
| NPI Last Update Date: | 04/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | E.0003749 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |