Provider Demographics
NPI:1093065435
Name:FAMILY ENHANCEMENT & COUNSELING GROUP, LLC
Entity Type:Organization
Organization Name:FAMILY ENHANCEMENT & COUNSELING GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BANCROFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-262-0515
Mailing Address - Street 1:500 5TH AVE S
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6615
Mailing Address - Country:US
Mailing Address - Phone:239-262-0515
Mailing Address - Fax:
Practice Address - Street 1:500 5TH AVE S
Practice Address - Street 2:SUITE 202
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6615
Practice Address - Country:US
Practice Address - Phone:239-262-0515
Practice Address - Fax:650-362-0515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-13
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2329106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty