Provider Demographics
NPI:1295747285
Name:FAMILY BEHAVIORAL SERVICES, LLC
Entity type:Organization
Organization Name:FAMILY BEHAVIORAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:NADEGE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:FEVRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-270-3200
Mailing Address - Street 1:1835 UNIVERSITY BLVD E STE 316
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-4672
Mailing Address - Country:US
Mailing Address - Phone:301-270-3200
Mailing Address - Fax:301-270-4600
Practice Address - Street 1:1835 UNIVERSITY BLVD E STE 316
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-4672
Practice Address - Country:US
Practice Address - Phone:301-270-3200
Practice Address - Fax:301-270-4600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD406060100Medicaid