Provider Demographics
NPI:1548604606
Name:MILITARY FAMILY SERVICES
Entity Type:Organization
Organization Name:MILITARY FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTUVE
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLPHUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-526-3288
Mailing Address - Street 1:2879 HIGHWAY 160 W STE 4388
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-8581
Mailing Address - Country:US
Mailing Address - Phone:803-526-3288
Mailing Address - Fax:803-675-5233
Practice Address - Street 1:2879 HIGHWAY 160 W STE 4388
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-8581
Practice Address - Country:US
Practice Address - Phone:803-526-3288
Practice Address - Fax:803-675-5233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC=========OtherTRI-CARE