THE FAMILY CENTER COUNSELING ASSOCIATES PLLC

Provider Demographics

• NPI: 1861571507
• Name: THE FAMILY CENTER COUNSELING ASSOCIATES PLLC
• Entity type: Organization
• Organization Name: THE FAMILY CENTER COUNSELING ASSOCIATES PLLC
• Other - Org Name: <UNAVAIL>
• Authorized Official - Title/Position: EXECUTIVE DIRECTOR
• Authorized Official - Prefix: DR
• Authorized Official - First Name: GLORY
• Authorized Official - Middle Name: FOX
• Authorized Official - Last Name: DIERKER
• Authorized Official - Credentials: PHD
• Authorized Official - Phone: 703-998-5606
• Mailing Address - Street 1: 5691 COLUMBIA PIKE
• Mailing Address - Street 2: SUITE 200
• Mailing Address - City: FALLS CHURCH
• Mailing Address - State: VA
• Mailing Address - Zip Code: 22041
• Mailing Address - Country: US
• Mailing Address - Phone: 703-998-5606
• Mailing Address - Fax: 703-998-5608
• Practice Address - Street 1: 5691 COLUMBIA PIKE
• Practice Address - Street 2: SUITE 200
• Practice Address - City: FALLS CHURCH
• Practice Address - State: VA
• Practice Address - Zip Code: 22041
• Practice Address - Country: US
• Practice Address - Phone: 703-998-5606
• Practice Address - Fax: 703-998-5608
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-11-03
• Last Update Date: 2015-01-09

Provider Licenses

State	License ID	Taxonomies
VA	07010001557	101YP2500X
VA	0701003275	101YP2500X
VA	0810002996	103TC0700X
VA	0810003091	103TC0700X
VA	0810003059	103TC0700X
VA	0810003411	103TC0700X
VA	0810003272	103TC0700X
VA	0810003575	103TC0700X
VA	0810003667	103TC0700X
VA	0717000025	106H00000X
VA	0701001168	101YP2500X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	101YP2500X	Behavioral Health & Social Service Providers	Counselor	Professional	Group - Multi-Specialty
No	103TC0700X	Behavioral Health & Social Service Providers	Psychologist	Clinical	Group - Multi-Specialty
No	106H00000X	Behavioral Health & Social Service Providers	Marriage & Family Therapist		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
	149749000	Other	DEPARTMENT OF LABOR GLORY
	28110014	Other	CAREFIRST FRAN
	28110003	Other	CAREFIRST MARJORIE
	141701	Other	ANTHEM BCBS GLORY
	149749000	Other	DEPARTMENT OF LABOR FRAN
	28110019	Other	CAREFIRST ERIKA
	461335000	Other	MAGELLAN GLORY
	775900000	Other	MAGELLAN RICH
	097480	Other	ANTHEM BCBS MARJORIE
	28110004	Other	CAREFIRST GLORY
	254707000	Other	MAGELLAN MARJORIE
	764249000	Other	MAGELLAN FAMILY CENTER
	554781000	Other	MAGELLAN FRAN
	818692000	Other	MAGELLAN ERIKA
	175319	Other	ANTHEM BCBS GUS
	28110017	Other	CAREFIRST RICH
	28110017	Other	CAREFIRST RICH
	149749000	Other	DEPARTMENT OF LABOR FRAN
	28110012	Other	CAREFIRST RACHEL
	175319	Other	ANTHEM BCBS GUS