Provider Demographics
NPI:1053449819
Name:FAMILY THERAPY CENTER
Entity Type:Organization
Organization Name:FAMILY THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:W
Authorized Official - Last Name:HALLWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFTLPC
Authorized Official - Phone:931-490-0999
Mailing Address - Street 1:PO BOX 475
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38402-0475
Mailing Address - Country:US
Mailing Address - Phone:931-490-0999
Mailing Address - Fax:931-490-0555
Practice Address - Street 1:854 W JAMES CAMPBELL BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4659
Practice Address - Country:US
Practice Address - Phone:931-490-0999
Practice Address - Fax:931-490-0555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty