Provider Demographics
NPI:1629292693
Name:MARRIAGE AND FAMILY COUNSELING SERVICE
Entity Type:Organization
Organization Name:MARRIAGE AND FAMILY COUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:HIEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:309-786-4491
Mailing Address - Street 1:1800 3RD AVE
Mailing Address - Street 2:SUITE 512
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-8026
Mailing Address - Country:US
Mailing Address - Phone:309-786-4491
Mailing Address - Fax:
Practice Address - Street 1:1800 3RD AVE
Practice Address - Street 2:SUITE 512
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-8026
Practice Address - Country:US
Practice Address - Phone:309-786-4491
Practice Address - Fax:309-786-0205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health