Provider Demographics
NPI:1417273327
Name:DENTON COUNTY FRIENDS OF THE FAMILY
Entity Type:Organization
Organization Name:DENTON COUNTY FRIENDS OF THE FAMILY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TONI
Authorized Official - Middle Name:LA FON
Authorized Official - Last Name:JOHNSON-SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:940-387-5131
Mailing Address - Street 1:PO BOX 640
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76202-0640
Mailing Address - Country:US
Mailing Address - Phone:940-387-5131
Mailing Address - Fax:940-383-1816
Practice Address - Street 1:1400 CRESCENT ST
Practice Address - Street 2:SUITE 5
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2757
Practice Address - Country:US
Practice Address - Phone:940-387-5131
Practice Address - Fax:940-383-1816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14319101Y00000X
TX33601103T00000X
TX41915104100000X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty