Provider Demographics
NPI:1467578575
Name:FAMILY CARE COUNSELING SERVICES, LCSW,P.C.
Entity Type:Organization
Organization Name:FAMILY CARE COUNSELING SERVICES, LCSW,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:VAN ESSENDELFT
Authorized Official - Suffix:
Authorized Official - Credentials:L-RCSW
Authorized Official - Phone:631-744-5500
Mailing Address - Street 1:595 ROUTE 25A STE 20
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-2647
Mailing Address - Country:US
Mailing Address - Phone:631-744-5500
Mailing Address - Fax:631-744-5677
Practice Address - Street 1:595 ROUTE 25A STE 20
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-2647
Practice Address - Country:US
Practice Address - Phone:631-744-5500
Practice Address - Fax:631-744-5677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0402321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty