Provider Demographics
NPI:1538249354
Name:CHRISTIAN COUNSELING AND RECONCILIATION INC
Entity type:Organization
Organization Name:CHRISTIAN COUNSELING AND RECONCILIATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHWARZ
Authorized Official - Suffix:
Authorized Official - Credentials:ED D
Authorized Official - Phone:508-695-0517
Mailing Address - Street 1:955 FAIRVIEW ST
Mailing Address - Street 2:
Mailing Address - City:LEE
Mailing Address - State:MA
Mailing Address - Zip Code:01238-9305
Mailing Address - Country:US
Mailing Address - Phone:508-695-0517
Mailing Address - Fax:508-695-0517
Practice Address - Street 1:955 FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:LEE
Practice Address - State:MA
Practice Address - Zip Code:01238-9305
Practice Address - Country:US
Practice Address - Phone:508-695-0517
Practice Address - Fax:508-695-0517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW10442OtherBLUE CROSS BLUE SHIELD
MAW10442OtherBLUE CROSS BLUE SHIELD
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