Provider Demographics
NPI:1265079206
Name:FAMILYCARE COUNSELING SOLUTIONS LLC
Entity type:Organization
Organization Name:FAMILYCARE COUNSELING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAMMELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:859-391-4510
Mailing Address - Street 1:912 BANKLICK ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-3029
Mailing Address - Country:US
Mailing Address - Phone:859-391-4510
Mailing Address - Fax:
Practice Address - Street 1:525 W 5TH ST STE 116
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-1260
Practice Address - Country:US
Practice Address - Phone:859-391-4510
Practice Address - Fax:859-993-0073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-10
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100653170Medicaid
KY7100326090Medicaid