Family Success Consortium Inc | |
2650 Madison Rd Cincinnati OH 45208-1332 | |
(513) 772-9300 | |
(513) 772-9302 |
Full Name | Family Success Consortium Inc |
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Speciality | Psychologist |
Location | 2650 Madison Rd, Cincinnati, Ohio |
Authorized Official Name and Position | Mark Kendal Evans (PSYCHOLOGIST) |
Authorized Official Contact | 5137729300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Family Success Consortium Inc 2650 Madison Rd Cincinnati OH 45208-1332 Ph: (513) 772-9300 | Family Success Consortium Inc 2650 Madison Rd Cincinnati OH 45208-1332 Ph: (513) 772-9300 |
NPI Number | 1942520648 |
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Provider Enumeration Date | 06/03/2010 |
Last Update Date | 06/24/2010 |
Medicare PECOS PAC ID | 3375585813 |
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Medicare Enrollment ID | O20120409000473 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942520648 | NPI | - | NPPES |
0903848 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 4512 (Ohio) | Primary |
Provider Name | Mark Kendal Evans |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1437373487 PECOS PAC ID: 6103957444 Enrollment ID: I20120409000450 |
Provider Name | Margaret Rinck |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1659595262 PECOS PAC ID: 4587811807 Enrollment ID: I20120821001070 |
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