Provider Demographics
NPI:1659752640
Name:FAMILY CENTER OF PSYCHOTHERAPY/PSYCHIATRY & EVALUATION
Entity Type:Organization
Organization Name:FAMILY CENTER OF PSYCHOTHERAPY/PSYCHIATRY & EVALUATION
Other - Org Name:FAMILY COPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:FILES-HALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:941-224-8131
Mailing Address - Street 1:7345 INTERNATIONAL PL STE 109
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34240-8468
Mailing Address - Country:US
Mailing Address - Phone:941-702-9978
Mailing Address - Fax:941-203-4822
Practice Address - Street 1:7345 INTERNATIONAL PL STE 109
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34240-8468
Practice Address - Country:US
Practice Address - Phone:941-702-9978
Practice Address - Fax:941-203-4822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6987103TC0700X
FLME1106912084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty