Provider Demographics
NPI:1174582902
Name:CC COUNSELING, INC.
Entity type:Organization
Organization Name:CC COUNSELING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:V.P. OF ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:LENTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-242-3070
Mailing Address - Street 1:24 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-1745
Mailing Address - Country:US
Mailing Address - Phone:717-242-3070
Mailing Address - Fax:717-248-4424
Practice Address - Street 1:24 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1745
Practice Address - Country:US
Practice Address - Phone:717-242-3070
Practice Address - Fax:717-248-4424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA447019101YA0400X, 261QR0405X
PA347018101YA0400X, 261QR0405X
PA147024101YA0400X, 261QR0405X
PA557050101YA0400X, 261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007648690010Medicaid
PA1007648690012Medicaid
PA1007648690003Medicaid
PA1007648690008Medicaid