Provider Demographics
NPI:1750254579
Name:FAMILY THERAPY CENTER OF THE SOUTHEAST LLC
Entity type:Organization
Organization Name:FAMILY THERAPY CENTER OF THE SOUTHEAST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:JAMIESON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:336-371-7157
Mailing Address - Street 1:PO BOX 2095
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-0001
Mailing Address - Country:US
Mailing Address - Phone:336-317-7157
Mailing Address - Fax:
Practice Address - Street 1:3508 CHESAPEAKE DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-6386
Practice Address - Country:US
Practice Address - Phone:336-317-7157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty