NPIMap

Organization Active NPI

Family Counseling Center, Inc.

  • Psychiatry Physician
  • Poplar Bluff, MO
National Provider Identifier
1174516942
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
118304 Issued in MO
Legal business name
FAMILY COUNSELING CENTER, INC.
Practice address
1140 Three Rivers Blvd
Poplar Bluff, MO 63901-3075
Phone
(573) 686-1200
Fax
(573) 778-7265
NPI assigned
Aug 26, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ravdeep S. Khanuja, M.D.NPI 1750433256
Title
Attending Psychiatrist
Phone
(573) 686-1200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 118304 MO Primary

Addresses

Primary practice location

1140 Three Rivers Blvd
Poplar Bluff, MO 63901-3075

Mailing address

1140 Three Rivers Blvd
Poplar Bluff, MO 63901-3075
Phone (573) 686-1200

National Provider Directory

National Provider Directory
Tax ID family
Family Counseling Ctr22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

1140 Three Rivers Blvd
Poplar Bluff, MO 63901

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174516942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 THREE RIVERS BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013075",
            "telephone_number": "573-686-1200",
            "fax_number": "573-778-7265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 THREE RIVERS BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013075",
            "telephone_number": "573-686-1200",
            "fax_number": "573-778-7265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KHANUJA",
        "authorized_official_first_name": "RAVDEEP",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "ATTENDING PSYCHIATRIST",
        "authorized_official_telephone_number": "573-686-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "118304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.