Provider Demographics
NPI:1548296023
Name:FAMILY AND COUPLE THERAPY SERVICES, INC.
Entity type:Organization
Organization Name:FAMILY AND COUPLE THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:JERRY
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LCMFT
Authorized Official - Phone:410-838-2493
Mailing Address - Street 1:2018 ROCK SPRING RD
Mailing Address - Street 2:A-6
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-2631
Mailing Address - Country:US
Mailing Address - Phone:410-838-2493
Mailing Address - Fax:410-838-2597
Practice Address - Street 1:2018 ROCK SPRING RD
Practice Address - Street 2:A-6
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-2631
Practice Address - Country:US
Practice Address - Phone:410-838-2493
Practice Address - Fax:410-838-2597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM003106H00000X
MDLCM002106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD=========OtherVARIOUS INS. CARRIERS