Provider Demographics
NPI:1831895101
Name:FERGUS FALLS FAMILY COUNSELING
Entity type:Organization
Organization Name:FERGUS FALLS FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMERA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHURCHILL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:218-205-1079
Mailing Address - Street 1:23866 CANTERBURY LN
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-8113
Mailing Address - Country:US
Mailing Address - Phone:218-205-1079
Mailing Address - Fax:
Practice Address - Street 1:116 E LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2217
Practice Address - Country:US
Practice Address - Phone:218-205-1079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty