Provider Demographics
NPI:1912288747
Name:FAMILY INTEGRATED COUNSELING SERVICES
Entity Type:Organization
Organization Name:FAMILY INTEGRATED COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV QMHP
Authorized Official - Phone:804-437-4986
Mailing Address - Street 1:4001 SPRINGFIELD RD
Mailing Address - Street 2:200
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-4181
Mailing Address - Country:US
Mailing Address - Phone:804-437-4986
Mailing Address - Fax:
Practice Address - Street 1:4001 SPRINGFIELD RD
Practice Address - Street 2:200
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-4181
Practice Address - Country:US
Practice Address - Phone:804-437-4986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health