FPC Intensive Outpatient Program

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

FPC INTENSIVE OUTPATIENT PROGRAM

Practice address

210 E Main St Ste 2C
Tupelo, MS 38804-4017

Phone

(662) 760-0052

Fax

(662) 495-4080

NPI assigned

Jul 25, 2022

Organization subpart

Yes

Parent organization

FAIR PARK COUNSELING PLLCAs reported in NPPES

Name

Madison Michelle Ashby

Title

Administrative Assistant

Phone

(662) 871-6657

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Fair Park Counseling PLLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Tupelo, MS
  • NPI 1730661331
  NPPES parent name

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

• Fair Park Counseling PLLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Tupelo, MS
  • NPI 1730661331
  NPD tax ID

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

• Kelly Wayne Ferguson, MA, LMFT

  • Addiction (Substance Use Disorder) Counselor
  • Oxford, MS
  • NPI 1568722874

  Addiction (Substance Use Disorder)

  NPD

Tax ID family

Fair Park Counseling PLLC (2 organizations share this tax ID)

Part of

Fair Park Counseling PLLC

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 25, 2022.

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1306572235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E MAIN ST STE 2C",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388044017",
            "telephone_number": "662-760-0052",
            "fax_number": "662-495-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E MAIN ST STE 2C",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388044017",
            "telephone_number": "662-760-0052",
            "fax_number": "662-495-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FPC INTENSIVE OUTPATIENT PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAIR PARK COUNSELING PLLC",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "ASHBY",
        "authorized_official_first_name": "MADISON",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "662-871-6657"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack B Foster Jr., MD
• Robert Foster, NP
• Robert Lee Foster, D.C.
• Robert Stacy Foster II
• Sara Fowler
• Thomas Francis, RPH
• Joannie Franklin, MD
• Katy Franks, DO
• Lauren B Franks
• Melissa Franks, RN

• All providers in Tupelo, MS
• Addiction (Substance Use Disorder) Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.