Provider Demographics
NPI:1275769200
Name:FAMILIES 1ST COUNSELING, PLLC
Entity Type:Organization
Organization Name:FAMILIES 1ST COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TOMEKA
Authorized Official - Middle Name:DAVIS
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:910-797-5661
Mailing Address - Street 1:346 WAGONER DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-4680
Mailing Address - Country:US
Mailing Address - Phone:910-864-0179
Mailing Address - Fax:910-864-3162
Practice Address - Street 1:346 WAGONER DR
Practice Address - Street 2:SUITE 106
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4680
Practice Address - Country:US
Practice Address - Phone:910-864-0179
Practice Address - Fax:910-864-3162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-04
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7255101YM0800X, 101YP2500X, 251S00000X, 252Y00000X
NC1596103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC437554OtherTRICARE
NC6104094Medicaid
NC151XROtherBCBS
NC13857OtherBCBS
NC6107612Medicaid