Provider Demographics
NPI:1952519787
Name:FAMILY TREE COUNSELING INC.
Entity type:Organization
Organization Name:FAMILY TREE COUNSELING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:401-785-0608
Mailing Address - Street 1:50 KEITH AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-5724
Mailing Address - Country:US
Mailing Address - Phone:401-785-0608
Mailing Address - Fax:401-785-6042
Practice Address - Street 1:50 KEITH AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-5724
Practice Address - Country:US
Practice Address - Phone:401-785-0608
Practice Address - Fax:401-785-6042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW 4831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1022260OtherBEACON HEALTH STRATEGIES
RIFT00129Medicaid