| Family Success Consortium Inc | |
|
11497 Springfield Pike Cincinnati OH 45246-3551 | |
| (513) 772-9300 | |
| (513) 772-9302 |
| Full Name | Family Success Consortium Inc |
|---|---|
| Speciality | Psychologist |
| Location | 11497 Springfield Pike, Cincinnati, Ohio |
| Authorized Official Name and Position | Mark Kendal Evans (PSYCHOLOGIST/PRESIDENT) |
| Authorized Official Contact | 5137729300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Success Consortium Inc 11497 Springfield Pike Cincinnati OH 45246-3551 Ph: (513) 772-9300 | Family Success Consortium Inc 11497 Springfield Pike Cincinnati OH 45246-3551 Ph: (513) 772-9300 |
| NPI Number | 1275724916 |
|---|---|
| Provider Enumeration Date | 08/07/2007 |
| Last Update Date | 06/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275724916 | NPI | - | NPPES |
| 0903848 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 4512 (Ohio) | Primary |
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