Organization
COMMUNITY COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMBER MALESCHA DEROUEN MS, LPC (LICENSED PROF. COUNSELOR/THERAPIST)
(409) 963-2331
Entity
Organization
Contact information
Practice address
4757 MAIN AVE, GROVES, TX 77619-4740
(409) 963-2331
(409) 963-2346
Mailing address
4757 MAIN AVE, GROVES, TX 77619-4740
(409) 963-2331
(409) 963-2346
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
18834
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164006202
—
TX
Enumeration date
08/15/2005
Last updated
08/22/2008
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