Provider Demographics
NPI:1427082460
Name:FAMILY COUNSELING SERVICES PLLC
Entity type:Organization
Organization Name:FAMILY COUNSELING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RITA
Authorized Official - Middle Name:K
Authorized Official - Last Name:LUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-483-2864
Mailing Address - Street 1:PO BOX 3626
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39303-3626
Mailing Address - Country:US
Mailing Address - Phone:601-483-2864
Mailing Address - Fax:601-483-2806
Practice Address - Street 1:4940 HIGHWAY 39 N
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-1019
Practice Address - Country:US
Practice Address - Phone:601-483-2864
Practice Address - Fax:601-483-2806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09014459Medicaid
MSC02207Medicare PIN