Provider Demographics
NPI:1760008080
Name:FAMILY NEST COUNSELING
Entity Type:Organization
Organization Name:FAMILY NEST COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:M ED
Authorized Official - Phone:570-204-7113
Mailing Address - Street 1:1000 MARKET ST STE 41
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-2601
Mailing Address - Country:US
Mailing Address - Phone:570-204-7113
Mailing Address - Fax:570-543-4962
Practice Address - Street 1:1000 MARKET ST STE 41
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-2601
Practice Address - Country:US
Practice Address - Phone:570-204-7113
Practice Address - Fax:570-543-4962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-23
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103220118001Medicaid