NPIMap

Organization Active NPI

Family Life Counseling & Psychiatric Services

  • Community/Behavioral Health Agency
  • Mansfield, OH
National Provider Identifier
1396093779
Registry record updated Aug 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FAMILY LIFE COUNSELING & PSYCHIATRIC SERVICES
Practice address
151 Marion Ave
Mansfield, OH 44903-2223
Phone
(419) 774-9969
NPI assigned
Aug 16, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2012

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

Authorized official

Name
Dr. Steven Burggraf, PHD
Title
Ceo
Phone
(419) 774-9969

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X OH Primary

Addresses

Primary practice location

151 Marion Ave
Mansfield, OH 44903-2223

Mailing address

151 Marion Ave
Mansfield, OH 44903-2223
Phone (419) 774-9969

Other identifiers 1

IdentifierTypeStateIssuer
2846764MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Family Life Counseling5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345075200000",
    "number": "1396093779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 MARION AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032223",
            "telephone_number": "419-774-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MARION AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032223",
            "telephone_number": "419-774-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY LIFE COUNSELING & PSYCHIATRIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-16",
        "last_updated": "2012-08-16",
        "status": "A",
        "authorized_official_last_name": "BURGGRAF",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-774-9969",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2846764",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; 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.