Provider Demographics
NPI:1063488773
Name:FAMILY WORKS PSYCHOLOGICAL CENTER
Entity type:Organization
Organization Name:FAMILY WORKS PSYCHOLOGICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:TOREN
Authorized Official - Last Name:KASHGARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:910-231-3761
Mailing Address - Street 1:2002 EASTWOOD ROAD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403
Mailing Address - Country:US
Mailing Address - Phone:910-231-3761
Mailing Address - Fax:910-509-0586
Practice Address - Street 1:2002 EASTWOOD ROAD
Practice Address - Street 2:SUITE 303
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403
Practice Address - Country:US
Practice Address - Phone:910-509-0588
Practice Address - Fax:910-509-0586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101Y00000X, 103T00000X, 103TB0200X, 103TF0000X, 103TS0200X, 104100000X, 1041C0700X, 106H00000X, 2084P0800X, 261QM0850X
NC4219101YM0800X
NC2612103T00000X, 103TC2200X
NC100464363A00000X
NC2550103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6006920Medicaid
NC607006600OtherUS DEPT OF LABOR
NC5906686Medicaid
NC5914700Medicaid
NC6005231Medicaid
NC015EAOtherBCBS
NC5913436Medicaid
NC6005196Medicaid
NC6005231Medicaid