Provider Demographics
NPI:1639443963
Name:FAMILY ADVOCACY NETWORK, INC.
Entity Type:Organization
Organization Name:FAMILY ADVOCACY NETWORK, INC.
Other - Org Name:FAMILY ADVOCACY NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:301-322-1238
Mailing Address - Street 1:8601 MARTIN LUTHER KING JR HWY STE 4
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1560
Mailing Address - Country:US
Mailing Address - Phone:301-322-1238
Mailing Address - Fax:301-322-1239
Practice Address - Street 1:8601 MARTIN LUTHER KING JR HWY STE 4
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-1560
Practice Address - Country:US
Practice Address - Phone:301-322-1238
Practice Address - Fax:301-322-1239
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY ADVOCACY NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01027251S00000X
DCPRC350251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC147994100OtherOFFICE OF WORKER'S COMPENSATION PROGRAMS DIVISION OF FEDERAL EMPLOYEES