Provider Demographics
NPI:1922825371
Name:CULTIVATING CONNECTIONS THERAPEUTIC & CONSULTING SERVICES
Entity type:Organization
Organization Name:CULTIVATING CONNECTIONS THERAPEUTIC & CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHEREESE
Authorized Official - Middle Name:L
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-409-6058
Mailing Address - Street 1:PO BOX 61
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:MT
Mailing Address - Zip Code:59828-0061
Mailing Address - Country:US
Mailing Address - Phone:406-409-6058
Mailing Address - Fax:
Practice Address - Street 1:274 OLD CORVALLIS RD STE W
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-3213
Practice Address - Country:US
Practice Address - Phone:406-409-6058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-25
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty