Provider Demographics
NPI:1609326842
Name:FAMILY SUPPORT SERVICES
Entity Type:Organization
Organization Name:FAMILY SUPPORT SERVICES
Other - Org Name:FAMILY THERAPEUTIC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR/CLINICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:W,
Authorized Official - Last Name:SEWARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-606-2783
Mailing Address - Street 1:218 CARROLL PKWY
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4914
Mailing Address - Country:US
Mailing Address - Phone:301-606-2783
Mailing Address - Fax:
Practice Address - Street 1:300 W. PATRICK ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4914
Practice Address - Country:US
Practice Address - Phone:301-606-2783
Practice Address - Fax:
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
MD18523251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health