Provider Demographics
NPI:1902175516
Name:COACHING, COUNSELING & MENTORING SERVICES, INC.
Entity Type:Organization
Organization Name:COACHING, COUNSELING & MENTORING SERVICES, INC.
Other - Org Name:CCMS, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCHEAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LMFT & LMHC
Authorized Official - Phone:641-580-0423
Mailing Address - Street 1:LATIMER POST OFFICE
Mailing Address - Street 2:BOX 476
Mailing Address - City:LATIMER
Mailing Address - State:IA
Mailing Address - Zip Code:50452
Mailing Address - Country:US
Mailing Address - Phone:641-580-0423
Mailing Address - Fax:509-461-5656
Practice Address - Street 1:207 HARRIMAN ST
Practice Address - Street 2:
Practice Address - City:ALEXANDER
Practice Address - State:IA
Practice Address - Zip Code:50420-8062
Practice Address - Country:US
Practice Address - Phone:641-580-0423
Practice Address - Fax:509-461-5656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0320251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health