COMMUNITY COUNSELING CLINIC LLC NPI 1942337076

NPI Information

NPI: 1942337076
Provider Name: COMMUNITY COUNSELING CLINIC LLC
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
2642 MAIN ST
UNION GAP, WA
ZIP 98903
Phone: (509) 452-6546
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COMMUNITY COUNSELING CLINIC LLC is an addiction (substance use disorder) counselor in Union Gap, WA. COMMUNITY COUNSELING CLINIC LLC NPI is 1942337076. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2642 MAIN ST
UNION GAP, WA
ZIP 98903-752
Phone: (509) 452-6546
Fax: (509) 452-6965

The provider's authorized official is Carolyn Kay Fries .
The authorized official title is Administrator Sr Member and has the following contact phone number (509) 452-6546.

The enumeration date for this NPI number is 2/27/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)		WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1995448	MEDICAID	WASHINGTON
2	7500CO	OTHER	WASHINGTON	REGENCE BLUE SHIELD
3	A7570	OTHER	WASHINGTON	PREMERA BLUE CROSS
4	CP00002903	OTHER	WASHINGTON	DARRELL G FRIES CDP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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