Provider Demographics
NPI:1649830530
Name:THE FAMILY MINISTRY COUNSELING AND PSYCOTHERAPY SERVICE
Entity type:Organization
Organization Name:THE FAMILY MINISTRY COUNSELING AND PSYCOTHERAPY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:602-283-4524
Mailing Address - Street 1:700 E JEFFERSON ST STE 245
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-2204
Mailing Address - Country:US
Mailing Address - Phone:602-616-4433
Mailing Address - Fax:602-283-4021
Practice Address - Street 1:700 E JEFFERSON ST STE 245
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-2204
Practice Address - Country:US
Practice Address - Phone:602-616-4433
Practice Address - Fax:602-283-4021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty