Organization Name: | COMMUNITY COUNSELING CENTER |
NPI Number: | 1154323566 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMBER MALESCHA DEROUEN (LICENSED PROF. COUNSELOR/THERAPIST) |
Mailing Address: | 4757 Main Ave Groves |
State: | TX US |
Postal Code: | 776194740 |
Phone Number: | 4099632331 |
Fax Number: | 4099632346 |
NPI Enumeration Date: | 08/15/2005 |
NPI Last Update Date: | 08/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 18834 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |