Provider Demographics
NPI:1568912707
Name:FAMILY CONNECTIONS COUNSELING SERVICES
Entity Type:Organization
Organization Name:FAMILY CONNECTIONS COUNSELING SERVICES
Other - Org Name:DR. PENNY L. SPRECHER
Other - Org Type:Other Name
Authorized Official - Title/Position:CREDENTIALING ASSOCIATE
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-768-0295
Mailing Address - Street 1:12801 IRON BRIDGE RD STE 400
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-1669
Mailing Address - Country:US
Mailing Address - Phone:804-768-0295
Mailing Address - Fax:804-768-8001
Practice Address - Street 1:12801 IRON BRIDGE RD STE 400
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1669
Practice Address - Country:US
Practice Address - Phone:804-768-0295
Practice Address - Fax:804-768-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001349103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0000779934Medicaid
VA620000156Medicare Oscar/Certification