Provider Demographics
NPI:1669888384
Name:FAMILYCARE COUNSELING CENTER
Entity type:Organization
Organization Name:FAMILYCARE COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICKEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MA,LMFT
Authorized Official - Phone:270-776-4751
Mailing Address - Street 1:215 BLUEGRASS RD
Mailing Address - Street 2:UNIT C
Mailing Address - City:FRANKLIN
Mailing Address - State:KY
Mailing Address - Zip Code:42134-2459
Mailing Address - Country:US
Mailing Address - Phone:270-253-3722
Mailing Address - Fax:270-253-3768
Practice Address - Street 1:215 BLUEGRASS RD
Practice Address - Street 2:UNIT C
Practice Address - City:FRANKLIN
Practice Address - State:KY
Practice Address - Zip Code:42134-2459
Practice Address - Country:US
Practice Address - Phone:270-253-3722
Practice Address - Fax:270-253-3768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1436101YM0800X
KY0348101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty