Provider Demographics
NPI:1295822021
Name:FAMILY CONSULTATION SERVICES, INC.
Entity Type:Organization
Organization Name:FAMILY CONSULTATION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:G. KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:619-280-3430
Mailing Address - Street 1:2525 CAMINO DEL RIO S
Mailing Address - Street 2:SUITE 315
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3717
Mailing Address - Country:US
Mailing Address - Phone:619-280-3430
Mailing Address - Fax:
Practice Address - Street 1:2525 CAMINO DEL RIO S
Practice Address - Street 2:SUITE 315
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3717
Practice Address - Country:US
Practice Address - Phone:619-280-3430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 6022106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty