| Family Life Counseling & Psychiatric Services | |
|
151 Marion Ave Mansfield OH 44903-2223 | |
| (419) 774-9969 | |
| (419) 756-5781 |
| Full Name | Family Life Counseling & Psychiatric Services |
|---|---|
| Speciality | Counselor |
| Location | 151 Marion Ave, Mansfield, Ohio |
| Authorized Official Name and Position | Steven B Burggraf (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4197749969 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Life Counseling & Psychiatric Services 151 Marion Ave Mansfield OH 44903-2223 Ph: (419) 774-9969 | Family Life Counseling & Psychiatric Services 151 Marion Ave Mansfield OH 44903-2223 Ph: (419) 774-9969 |
| NPI Number | 1598862641 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 07/16/2008 |
| Medicare PECOS PAC ID | 0749353464 |
|---|---|
| Medicare Enrollment ID | O20080714000402 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598862641 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 10440 (Ohio) | Secondary |
| 101YM0800X | Counselor - Mental Health | 0405 (Ohio) | Primary |
| Provider Name | Mary K Castor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801161195 PECOS PAC ID: 2668629528 Enrollment ID: I20120828000547 |
| Provider Name | Cheryl L Purviance |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336396977 PECOS PAC ID: 8426292327 Enrollment ID: I20130916000286 |
| Provider Name | Susan Kay Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114466372 PECOS PAC ID: 0446509756 Enrollment ID: I20180820003692 |
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