Provider Demographics
NPI:1255330874
Name:FAMILY COUNSELING SERVICE
Entity Type:Organization
Organization Name:FAMILY COUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-233-0033
Mailing Address - Street 1:535 W 2ND ST
Mailing Address - Street 2:SUITE L50
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-1284
Mailing Address - Country:US
Mailing Address - Phone:859-233-0033
Mailing Address - Fax:859-233-1269
Practice Address - Street 1:535 W 2ND ST
Practice Address - Street 2:SUITE L50
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-1284
Practice Address - Country:US
Practice Address - Phone:859-233-0033
Practice Address - Fax:859-233-1269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2477Medicare ID - Type UnspecifiedMENTAL HEALTH PROVIDER