NPIMap

Family Support Services, LLC

Organization Active NPI Clinical Social Worker · Decatur, AL

NPI 1023142189 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1023142189
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Social Worker 1041C0700X
License
0793-2015C (AL)
Legal business name
FAMILY SUPPORT SERVICES, LLC
Practice address
1608 4TH Ave SE
Decatur, AL 35601-4904
Phone
(256) 340-9233
Fax
(256) 796-1776
NPI assigned
Mar 14, 2007
Organization subpart
No

Authorized official

Name
Ms. Brandy Woods Holmes, LCSW
Title
President
Phone
(256) 340-9233

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070423000600 AL Part B Supplier - Clinic/Group Practice 8224133061 Receives reassigned benefits from 5 practitioners
Practice locations: Blountsville, AL; Cullman, AL; Decatur, AL; Huntsville, AL

National Provider Directory

Tax ID family
Family Support Services LLC (2 organizations share this tax ID)

Locations

1608 4th Ave SE
Decatur, AL 35601
Phone (256) 340-9233

2620 Memorial Pkwy NW
Ste C
Huntsville, AL 35810
Phone (256) 340-9233

604 Jordan Ln NW
Huntsville, AL 35816
Phone (256) 340-9233

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker
Group: 193400000X SINGLE SPECIALTY GROUP		 1041C0700X 0793-2015C AL Yes

Addresses

Primary practice location

1608 4TH Ave SE
Decatur, AL 35601-4904

Mailing address

1608 4TH Ave SE
Decatur, AL 35601-4904
Phone (256) 340-9233

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023142189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 4TH AVE SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014904",
            "telephone_number": "256-340-9233",
            "fax_number": "256-796-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 4TH AVE SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014904",
            "telephone_number": "256-340-9233",
            "fax_number": "256-796-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SUPPORT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_middle_name": "WOODS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-340-9233",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "0793-2015C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

All providers in Decatur, AL · Clinical Social Worker in Alabama

Sources for this page

Verify at the official NPI Registry.