Organization
PROVIDENCE COUNSELING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. C LAUDIA D DAVIS MSW, LCSW (PRESIDENT/CEO)
(260) 418-6765
Entity
Organization
Contact information
Practice address
10305 DAWSONS CREEK BLVD, SUITE C, FORT WAYNE, IN 46825-1914
(260) 418-6765
(260) 416-0601
Mailing address
PO BOX 5622, FORT WAYNE, IN 46895-5622
(260) 418-6765
(260) 416-0601
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004602A
IN
Other
Enumeration date
10/04/2006
Last updated
08/22/2020
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