Provider Demographics
NPI:1669732004
Name:FAMILY FIRST COUNSELING SERVICES
Entity type:Organization
Organization Name:FAMILY FIRST COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RAHILA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BASHIR
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:321-720-1709
Mailing Address - Street 1:1338 PORT MALABAR BLVD NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-5259
Mailing Address - Country:US
Mailing Address - Phone:321-720-1709
Mailing Address - Fax:321-733-1860
Practice Address - Street 1:2194 HWY A1A STE 203
Practice Address - Street 2:
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4931
Practice Address - Country:US
Practice Address - Phone:321-720-1708
Practice Address - Fax:321-773-5497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7753251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health