Provider Demographics
NPI:1154694669
Name:FAMILY COUNSELING OF COLUMBUS @ TH FAMILY CENTER OF COLUMBUS, INC
Entity type:Organization
Organization Name:FAMILY COUNSELING OF COLUMBUS @ TH FAMILY CENTER OF COLUMBUS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:KIBBY
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:706-327-3238
Mailing Address - Street 1:1350 15TH AVE
Mailing Address - Street 2:P.O. BOX 1825
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-2308
Mailing Address - Country:US
Mailing Address - Phone:706-327-3238
Mailing Address - Fax:706-327-5750
Practice Address - Street 1:1350 15TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-2308
Practice Address - Country:US
Practice Address - Phone:706-327-3238
Practice Address - Fax:706-327-5750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC002267101Y00000X
GALPC004658101YM0800X
GACSW001759101YM0800X
GAMFT000855106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty