Provider Demographics
NPI:1730220369
Name:FS I SERVICES, PLLC
Entity type:Organization
Organization Name:FS I SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:KETNER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:336-542-2076
Mailing Address - Street 1:208 E BESSEMER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-6320
Mailing Address - Country:US
Mailing Address - Phone:336-542-2076
Mailing Address - Fax:
Practice Address - Street 1:208 E BESSEMER AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-6320
Practice Address - Country:US
Practice Address - Phone:336-542-2076
Practice Address - Fax:336-272-1182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102159Medicaid
NC6103633Medicaid
NC6104176Medicaid
NC6103430Medicaid
NC6102338Medicaid
NC6102405Medicaid
NC6102356Medicaid
NC6103882Medicaid
NC6102357Medicaid
NC6103923Medicaid
NC6104302Medicaid
NC6106302Medicaid