Provider Demographics
NPI:1760263404
Name:FAMILY RESTORATION COUNSELING SERVICES
Entity Type:Organization
Organization Name:FAMILY RESTORATION COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ISABEL
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:413-439-3674
Mailing Address - Street 1:36 W BAY PATH TER
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01109-2243
Mailing Address - Country:US
Mailing Address - Phone:413-439-3674
Mailing Address - Fax:
Practice Address - Street 1:77 MILL ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01108-7701
Practice Address - Country:US
Practice Address - Phone:413-378-8936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty