1891859179 NPI number — FAMILY COUNSELING SERVICE OF DURHAM, 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 1891859179 NPI number — FAMILY COUNSELING SERVICE OF DURHAM, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY COUNSELING SERVICE OF DURHAM, 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:
1891859179
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:
1058 W CLUB BLVD
Provider Second Line Business Mailing Address:
SUITE 6662
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27701-1104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-416-4400
Provider Business Mailing Address Fax Number:
919-416-4404

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1058 W CLUB BLVD
Provider Second Line Business Practice Location Address:
SUITE 6662
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27701-1104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-416-4400
Provider Business Practice Location Address Fax Number:
919-416-4404
Provider Enumeration Date:
12/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HUNTOON
Authorized Official First Name:
ALBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
919-416-4400

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: 005689 . This is a "MAGELLAN BEHAVIORAL ID" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 107336 . This is a "UNITED BEHAVIORAL ID" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 6003809 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0181F . This is a "BCBSNC ID NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 118413 . This is a "BEHAVIORAL HEALTH ID" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com