Provider Demographics
NPI:1992942536
Name:FAMILY COUNSELING AGENCY
Entity type:Organization
Organization Name:FAMILY COUNSELING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSSALIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:318-448-0284
Mailing Address - Street 1:1605 MURRAY ST STE 101
Mailing Address - Street 2:P O BOX 1908
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-6875
Mailing Address - Country:US
Mailing Address - Phone:318-448-0284
Mailing Address - Fax:318-448-0280
Practice Address - Street 1:1605 MURRAY ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-6890
Practice Address - Country:US
Practice Address - Phone:318-448-0284
Practice Address - Fax:318-448-0280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-20
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health