Provider Demographics
NPI:1992819411
Name:FCP, INC
Entity type:Organization
Organization Name:FCP, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-522-5022
Mailing Address - Street 1:360 MERRIMACK ST
Mailing Address - Street 2:BUILDING 9, 3RD FLOOR, SUITE 355
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1740
Mailing Address - Country:US
Mailing Address - Phone:978-687-1617
Mailing Address - Fax:978-687-1597
Practice Address - Street 1:360 MERRIMACK ST
Practice Address - Street 2:BUILDING 9 3RD FLOOR
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1740
Practice Address - Country:US
Practice Address - Phone:978-620-2502
Practice Address - Fax:978-687-1597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA44XE251B00000X
MA4509251B00000X
MA4547251B00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA26Medicaid
MA110028091Medicaid
MA1308874Medicaid
MA1308874Medicaid