Faucette Child And Family Counseling, Inc. | |
1350 5th Ave Ste 320 Youngstown OH 44504-1765 | |
(330) 542-6573 | |
(202) 970-5606 |
Full Name | Faucette Child And Family Counseling, Inc. |
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Speciality | Counselor |
Location | 1350 5th Ave Ste 320, Youngstown, Ohio |
Authorized Official Name and Position | Carolyn Faucette (PSYCHOTHERAPIST, COUNSELOR) |
Authorized Official Contact | 3305426573 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Faucette Child And Family Counseling, Inc. 1350 5th Ave Ste 320 Youngstown OH 44504-1765 Ph: (330) 542-6573 | Faucette Child And Family Counseling, Inc. 1350 5th Ave Ste 320 Youngstown OH 44504-1765 Ph: (330) 542-6573 |
NPI Number | 1629430764 |
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Provider Enumeration Date | 03/28/2016 |
Last Update Date | 10/06/2023 |
Certification Date | 10/06/2023 |
Medicare PECOS PAC ID | 0446540892 |
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Medicare Enrollment ID | O20160526001267 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629430764 | NPI | - | NPPES |
1316247232 | Other | OH | INDIVIDUAL NPI |
0161000 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | I0900303S (Ohio) | Primary |
101YP2500X | Counselor - Professional | I0900303S (Ohio) | Secondary |
Provider Name | Carolyn Faucette |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1316247232 PECOS PAC ID: 5799966867 Enrollment ID: I20110222001019 |
Provider Name | Paulette S Brown |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1821408915 PECOS PAC ID: 5496049223 Enrollment ID: I20160802002077 |
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