Provider Demographics
NPI:1942498811
Name:PORTER COUNTY FAMILY COUNSELING CENTER
Entity Type:Organization
Organization Name:PORTER COUNTY FAMILY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SANGSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:219-464-3919
Mailing Address - Street 1:554 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-5441
Mailing Address - Country:US
Mailing Address - Phone:219-464-3919
Mailing Address - Fax:219-464-0126
Practice Address - Street 1:554 LOCUST ST
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-5441
Practice Address - Country:US
Practice Address - Phone:219-464-3919
Practice Address - Fax:219-464-0126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health