Provider Demographics
NPI:1568890044
Name:CENTER FOR INDIVIDUAL AND FAMILY COUNSELING INC
Entity Type:Organization
Organization Name:CENTER FOR INDIVIDUAL AND FAMILY COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:FURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-344-8494
Mailing Address - Street 1:30555 SOUTHFIELD RD
Mailing Address - Street 2:STE 340
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-1221
Mailing Address - Country:US
Mailing Address - Phone:248-443-8494
Mailing Address - Fax:248-443-8496
Practice Address - Street 1:30555 SOUTHFIELD RD
Practice Address - Street 2:STE 340
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-1221
Practice Address - Country:US
Practice Address - Phone:248-443-8494
Practice Address - Fax:248-443-8496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-22
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0961297OtherBCBS PIN