NPIMap

Organization Active NPI

Family Life Counseling & Psychiatric Services

  • Mental Health Counselor
  • Mansfield, OH
National Provider Identifier
1598862641
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0405 Issued in OH
Legal business name
FAMILY LIFE COUNSELING & PSYCHIATRIC SERVICES
Practice address
151 Marion Ave
Mansfield, OH 44903-2223
Phone
(419) 774-9969
Fax
(419) 756-5781
NPI assigned
Sep 20, 2006
Last updated
Jul 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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

Authorized official

Name
Dr. Steven B Burggraf, PHD, LPCCE, 1MFTNPI 1225252174
Title
Executive Director
Phone
(419) 774-9969

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 10440 OH
Mental Health Counselor 101YM0800X 0405 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080714000402 OH Part B Supplier - Clinic/Group Practice 0749353464 Receives reassigned benefits from 25 practitioners
1 other NPI on this enrollment
Practice locations: Galion, OH; Willard, OH; Shelby, OH; Norwalk, OH; Mount Vernon, OH; Mansfield, OH; Loudonville, OH; Danville, OH…

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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.

Locations

6 Public Sq
Galion, OH 44833
Phone (567) 560-3583

133 N Water St
Loudonville, OH 44842
Phone (567) 560-3151

240 Marion Ave
Mansfield, OH 44903
Phone (419) 756-8600

1095 Harcourt Rd
Mount Vernon, OH 43050
Phone (740) 848-1010

34 Woodlawn Ave
Norwalk, OH 44857
Phone (419) 774-9969

169 Mansfield Ave
Shelby, OH 44875
Phone (567) 292-9211

Practitioners & affiliated clinicians

Practitioners 42

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.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1598862641",
    "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",
            "fax_number": "419-756-5781"
        },
        {
            "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",
            "fax_number": "419-756-5781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY LIFE COUNSELING & PSYCHIATRIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "BURGGRAF",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "419-774-9969",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LPCCE, 1MFT"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "10440",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "0405",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.