NPIMap

Organization Active NPI

Family and Children Support, Inc

  • Clinical Social Worker
  • Rincon, GA
National Provider Identifier
1083071385
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
FAMILY AND CHILDREN SUPPORT, INC
Practice address
1115 N Columbia Ave
Unit 4
Rincon, GA 31326-6825
Phone
(800) 317-0364
NPI assigned
Jan 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kenoshia R Jackson
Title
Owner
Phone
(800) 317-0364

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1115 N Columbia Ave
Unit 4
Rincon, GA 31326-6825

Mailing address

1115 N Columbia Ave
Unit 4
Rincon, GA 31326-6825

National Provider Directory

National Provider Directory
Tax ID family
Family and Children Support Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1115 N Columbia Ave
Unit 4
Rincon, GA 31326
Phone (800) 317-0364

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1083071385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 N COLUMBIA AVE",
            "address_2": "UNIT 4",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313266825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 N COLUMBIA AVE",
            "address_2": "UNIT 4",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313266825",
            "telephone_number": "800-317-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY AND CHILDREN SUPPORT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KENOSHIA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "800-317-0364"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rincon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.