Provider Demographics
NPI:1801286455
Name:FAMILY COUNSELING CENTER INC
Entity type:Organization
Organization Name:FAMILY COUNSELING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NORABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HACKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-683-2461
Mailing Address - Street 1:PO BOX 759
Mailing Address - Street 2:
Mailing Address - City:GOLCONDA
Mailing Address - State:IL
Mailing Address - Zip Code:62938-0759
Mailing Address - Country:US
Mailing Address - Phone:618-683-2461
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 99AA
Practice Address - Street 2:
Practice Address - City:GOLCONDA
Practice Address - State:IL
Practice Address - Zip Code:62938-9619
Practice Address - Country:US
Practice Address - Phone:618-683-2461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health