1588744866 NPI number — FAMILY COUNSELING CENTER

Table of content: (NPI 1588744866)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588744866 NPI number — FAMILY COUNSELING CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY COUNSELING CENTER
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:
1588744866
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4356 BONNEY RD
Provider Second Line Business Mailing Address:
SUITE 2-101
Provider Business Mailing Address City Name:
VIRGINIA BEACH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23452-1200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-498-1135
Provider Business Mailing Address Fax Number:
757-498-7018

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4356 BONNEY RD
Provider Second Line Business Practice Location Address:
SUITE 2-101
Provider Business Practice Location Address City Name:
VIRGINIA BEACH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23452-1200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-498-1135
Provider Business Practice Location Address Fax Number:
757-498-7018
Provider Enumeration Date:
10/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCCARTHY
Authorized Official First Name:
TIMOTHY
Authorized Official Middle Name:
F.
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
757-498-1135

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 242436 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 89-3040-6 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 099737 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 326233 . This is a "MHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 320781 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 89-0420-1 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 89-4485-7 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 196222 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 452899 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 89-45195 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 098857 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 322092 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 439-3584 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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