Organization
COMMUNITY COUNSELING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL E SIPES CPA (CONTROLLER)
(419) 562-2000
Entity
Organization
Contact information
Practice address
2458 STETZER RD, BUCYRUS, OH 44820-2066
(419) 562-2000
Mailing address
2458 STETZER RD, PO BOX 765, BUCYRUS, OH 44820-2066
(419) 562-2000
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
1057
OH
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
0177
OH
261QM0850X
Adult Mental Health Clinic/Center
0177
OH
261QM0855X
Adolescent and Children Mental Health Clinic/Center
0177
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0177
ODMH CERTIFICATE NUMBER
OH
01
—
1057
ODADAS CERTIFICATE NUMBER
OH
05
—
2444653
—
OH
Enumeration date
02/28/2006
Last updated
02/26/2008
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