Organization
COMMUNITY COUNSELING CENTER, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY MARTIN (PRESIDENT)
(815) 338-7749
Entity
Organization
Contact information
Practice address
666 RUSSEL CT, 105, WOODSTOCK, IL 60098-2670
(815) 338-7749
(815) 338-7728
Mailing address
666 RUSSEL CT, 105, WOODSTOCK, IL 60098-2670
(815) 338-7749
(815) 338-7728
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05630307
BCBS
IL
Enumeration date
04/01/2007
Last updated
08/22/2020
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