Provider Demographics
NPI:1851882757
Name:FAMILY THERAPEUTIC SERVICES AND ASSESSMENTS INC.
Entity Type:Organization
Organization Name:FAMILY THERAPEUTIC SERVICES AND ASSESSMENTS INC.
Other - Org Name:DR. STACEY HELLOW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HELLOW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW
Authorized Official - Phone:772-529-0372
Mailing Address - Street 1:3086 SW FEROE AVE
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-2912
Mailing Address - Country:US
Mailing Address - Phone:772-529-0372
Mailing Address - Fax:
Practice Address - Street 1:819 SW FEDERAL HWY STE 200B
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2952
Practice Address - Country:US
Practice Address - Phone:772-529-0372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW10356261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)