Provider Demographics
NPI:1588744866
Name:FAMILY COUNSELING CENTER
Entity type:Organization
Organization Name:FAMILY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:F
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-498-1135
Mailing Address - Street 1:4356 BONNEY RD
Mailing Address - Street 2:SUITE 2-101
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1200
Mailing Address - Country:US
Mailing Address - Phone:757-498-1135
Mailing Address - Fax:757-498-7018
Practice Address - Street 1:4356 BONNEY RD
Practice Address - Street 2:SUITE 2-101
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1200
Practice Address - Country:US
Practice Address - Phone:757-498-1135
Practice Address - Fax:757-498-7018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
242436OtherBCBS
VA89-3040-6Medicaid
099737OtherBCBS
326233OtherMHN
320781OtherBCBS
VA89-0420-1Medicaid
VA89-4485-7Medicaid
196222OtherBCBS
452899OtherBCBS
VA89-45195Medicaid
098857OtherBCBS
322092OtherBCBS
439-3584OtherAETNA