Provider Demographics
NPI:1417063652
Name:FAMILY & CHILDREN FIRST
Entity Type:Organization
Organization Name:FAMILY & CHILDREN FIRST
Other - Org Name:FAMILY & CHILDREN'S COUNSELING CENTERS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:TEAM LEADER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLOS
Authorized Official - Middle Name:VERNELL
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSSW
Authorized Official - Phone:502-776-4200
Mailing Address - Street 1:2303 RIVER ROAD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-3784
Mailing Address - Country:US
Mailing Address - Phone:502-776-4200
Mailing Address - Fax:502-776-4280
Practice Address - Street 1:703 S 31ST ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40211-1410
Practice Address - Country:US
Practice Address - Phone:502-776-4200
Practice Address - Fax:502-776-4280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0339251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY07419542006OtherTHERAPIST