Provider Demographics
NPI:1245422849
Name:FAMILIES FIRST COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:FAMILIES FIRST COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HAYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA/LPC
Authorized Official - Phone:715-349-8913
Mailing Address - Street 1:PO BOX 381
Mailing Address - Street 2:
Mailing Address - City:SIREN
Mailing Address - State:WI
Mailing Address - Zip Code:54872-0381
Mailing Address - Country:US
Mailing Address - Phone:715-349-8913
Mailing Address - Fax:715-349-8981
Practice Address - Street 1:24178 FIRST AVENUE, STE 2
Practice Address - Street 2:
Practice Address - City:SIREN
Practice Address - State:WI
Practice Address - Zip Code:54872-0381
Practice Address - Country:US
Practice Address - Phone:715-349-8913
Practice Address - Fax:715-349-8981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2493101YM0800X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42233400Medicaid
MN384K0FAOtherBCBS MN
MN384K0FAOtherBCBS MN