Provider Demographics
NPI:1245241850
Name:FAMILY COUNSELING CENTER
Entity Type:Organization
Organization Name:FAMILY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:MILLER
Authorized Official - Last Name:MANDELL
Authorized Official - Suffix:
Authorized Official - Credentials:MSSA LISW
Authorized Official - Phone:513-697-0634
Mailing Address - Street 1:7577 CENTRAL PARKE BLVD
Mailing Address - Street 2:219
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6809
Mailing Address - Country:US
Mailing Address - Phone:513-770-3231
Mailing Address - Fax:513-770-5541
Practice Address - Street 1:7577 CENTRAL PARKE BLVD
Practice Address - Street 2:219
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6809
Practice Address - Country:US
Practice Address - Phone:513-770-3231
Practice Address - Fax:513-770-5541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0005085251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management