Provider Demographics
NPI:1285696906
Name:FAMILY COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:FAMILY COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:REHA
Authorized Official - Suffix:
Authorized Official - Credentials:LISW ACSW
Authorized Official - Phone:319-653-2032
Mailing Address - Street 1:110 N IOWA AVE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353
Mailing Address - Country:US
Mailing Address - Phone:319-653-2032
Mailing Address - Fax:319-653-2301
Practice Address - Street 1:110 N IOWA AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:WASHINGTON
Practice Address - State:IA
Practice Address - Zip Code:52353
Practice Address - Country:US
Practice Address - Phone:319-653-2032
Practice Address - Fax:319-653-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02141104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0450304Medicaid
IA36224OtherBCBS
I11363Medicare UPIN
IAI11295Medicare ID - Type Unspecified