Provider Demographics
NPI:1194158097
Name:FAMILY AND FORENSIC INTERVENTION COUNSELING SERVICES
Entity type:Organization
Organization Name:FAMILY AND FORENSIC INTERVENTION COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOY
Authorized Official - Middle Name:S
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-731-6333
Mailing Address - Street 1:7421 DOUGLAS BLVD STE 239
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1564
Mailing Address - Country:US
Mailing Address - Phone:404-731-6333
Mailing Address - Fax:678-348-7148
Practice Address - Street 1:7421 DOUGLAS BLVD STE 239
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1564
Practice Address - Country:US
Practice Address - Phone:678-448-8913
Practice Address - Fax:678-669-2594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-14
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006430101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty