1861571507 NPI number — THE FAMILY CENTER COUNSELING ASSOCIATES PLLC

Table of content: (NPI 1861571507)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861571507 NPI number — THE FAMILY CENTER COUNSELING ASSOCIATES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE FAMILY CENTER COUNSELING ASSOCIATES PLLC
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:
6
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:
1861571507
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5691 COLUMBIA PIKE
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
FALLS CHURCH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22041
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-998-5606
Provider Business Mailing Address Fax Number:
703-998-5608

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5691 COLUMBIA PIKE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
FALLS CHURCH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-998-5606
Provider Business Practice Location Address Fax Number:
703-998-5608
Provider Enumeration Date:
11/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DIERKER
Authorized Official First Name:
GLORY
Authorized Official Middle Name:
FOX
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
703-998-5606

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  07010001557 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 0701003275 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 0810002996 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 0810003091 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 0810003059 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 0810003411 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 0810003272 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 0810003575 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 0810003667 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: 0717000025 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 0701001168 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 149749000 . This is a "DEPARTMENT OF LABOR GLORY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 28110014 . This is a "CAREFIRST FRAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 28110003 . This is a "CAREFIRST MARJORIE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 141701 . This is a "ANTHEM BCBS GLORY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 149749000 . This is a "DEPARTMENT OF LABOR FRAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 28110019 . This is a "CAREFIRST ERIKA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 461335000 . This is a "MAGELLAN GLORY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 775900000 . This is a "MAGELLAN RICH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 097480 . This is a "ANTHEM BCBS MARJORIE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 28110004 . This is a "CAREFIRST GLORY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 254707000 . This is a "MAGELLAN MARJORIE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 764249000 . This is a "MAGELLAN FAMILY CENTER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 554781000 . This is a "MAGELLAN FRAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 818692000 . This is a "MAGELLAN ERIKA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 175319 . This is a "ANTHEM BCBS GUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 28110017 . This is a "CAREFIRST RICH" identifier . This identifiers is of the category "OTHER".




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