Provider Demographics
NPI:1164235271
Name:COMMUNITY COUNSELING CENTER OF ASHLAND
Entity type:Organization
Organization Name:COMMUNITY COUNSELING CENTER OF ASHLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOLLES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:541-840-5922
Mailing Address - Street 1:1136 ANDERSON CK RD
Mailing Address - Street 2:
Mailing Address - City:TALENT
Mailing Address - State:OR
Mailing Address - Zip Code:97540
Mailing Address - Country:US
Mailing Address - Phone:541-840-5922
Mailing Address - Fax:
Practice Address - Street 1:600 SISKIYOU BOULEVARD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520
Practice Address - Country:US
Practice Address - Phone:541-708-5436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable