1023140381 NPI number — FAMILY COUNSELING ASSOCIATES INC

Table of Contents

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: 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" .
  • 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" .

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".
  • Identifier: 004931800 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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