1205087236 NPI number — FAMILY FOCUS COUNSELING SERVICES, LLC

Table of content: ALYSSA RAQUEL VANASCO LAT, ATC (NPI 1184367666)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205087236 NPI number — FAMILY FOCUS COUNSELING SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY FOCUS COUNSELING SERVICES, LLC
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:
1205087236
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3824 N MERIDIAN AVE
Provider Second Line Business Mailing Address:
SUITE 104
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73112-2853
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-602-0835
Provider Business Mailing Address Fax Number:
405-602-0936

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3824 N MERIDIAN AVE
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
OKLAHOMA CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73112-2853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-602-0835
Provider Business Practice Location Address Fax Number:
405-602-0936
Provider Enumeration Date:
10/08/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SCHAEFER
Authorized Official First Name:
AMY
Authorized Official Middle Name:
ELIZABETH
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
405-819-0111

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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