| Family Counseling Center, Llc | |
|
2355 E Cedar Canyons Rd Fort Wayne IN 46845-9330 | |
| (260) 925-2017 | |
| (260) 925-9713 |
| Full Name | Family Counseling Center, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2355 E Cedar Canyons Rd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Judith L Williams (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2609252017 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Counseling Center, Llc Po Box 289 Edgerton OH 43517-0289 Ph: (260) 925-2017 | Family Counseling Center, Llc 2355 E Cedar Canyons Rd Fort Wayne IN 46845-9330 Ph: (260) 925-2017 |
| NPI Number | 1730480211 |
|---|---|
| Provider Enumeration Date | 11/15/2010 |
| Last Update Date | 09/01/2021 |
| Certification Date | 09/01/2021 |
| Medicare PECOS PAC ID | 3779762901 |
|---|---|
| Medicare Enrollment ID | O20110120000521 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730480211 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 20042458A (Indiana) | Primary |
| Provider Name | Judith L Williams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508848391 PECOS PAC ID: 0042499295 Enrollment ID: I20110120000639 |
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