1023140381 NPI number — FAMILY COUNSELING ASSOCIATES INC

Table of content: (NPI 1023140381)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023140381 NPI number — FAMILY COUNSELING ASSOCIATES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY COUNSELING ASSOCIATES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023140381
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4425 MILITARY TRAIL
Provider Second Line Business Mailing Address:
STE 203
Provider Business Mailing Address City Name:
JUPITER
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33458-4817
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-747-2775
Provider Business Mailing Address Fax Number:
561-747-1881

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4425 MILITARY TRAIL
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
JUPITER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33458-4817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-747-2775
Provider Business Practice Location Address Fax Number:
561-747-1881
Provider Enumeration Date:
03/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GUILLORY
Authorized Official First Name:
GAIL
Authorized Official Middle Name:
DIANE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
561-747-2775

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  4347 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 4786 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: SW5740 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: SW 4901 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: SW 5367 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: SW 6254 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: Z071W . This is a "MELISSA FEIN, LCSW BCBS#" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: Z8250 . This is a "JULIE AKERS, LCSW BCBS #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: Z013L . This is a "H KENDRIGAN,LCSW BCBS#" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: Z7718 . This is a "GAIL GUILLORY, LCSW BCBS#" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: Z087N . This is a "ELISA FRALEY, LCSW BCBS #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: Z120N . This is a "N STEINFELD, LCSW BCBS#" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: Z121J . This is a "BCBSFL PA GROUP #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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