Provider Demographics
NPI:1023140381
Name:FAMILY COUNSELING ASSOCIATES INC
Entity type:Organization
Organization Name:FAMILY COUNSELING ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:GUILLORY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-747-2775
Mailing Address - Street 1:4425 MILITARY TRAIL
Mailing Address - Street 2:STE 203
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-4817
Mailing Address - Country:US
Mailing Address - Phone:561-747-2775
Mailing Address - Fax:561-747-1881
Practice Address - Street 1:4425 MILITARY TRAIL
Practice Address - Street 2:SUITE 203
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-4817
Practice Address - Country:US
Practice Address - Phone:561-747-2775
Practice Address - Fax:561-747-1881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL43471041C0700X
FL47861041C0700X
FLSW 49011041C0700X
FLSW 53671041C0700X
FLSW 62541041C0700X
FLSW57401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ071WOtherMELISSA FEIN, LCSW BCBS#
FLZ8250OtherJULIE AKERS, LCSW BCBS #
FLZ013LOtherH KENDRIGAN,LCSW BCBS#
FLZ7718OtherGAIL GUILLORY, LCSW BCBS#
FLZ087NOtherELISA FRALEY, LCSW BCBS #
FLZ120NOtherN STEINFELD, LCSW BCBS#
FLZ121JOtherBCBSFL PA GROUP #