NPIMap

Organization Active NPI

Family Counseling Center, Inc.

  • Community/Behavioral Health Agency
  • Kennett, MO
National Provider Identifier
1669477550
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FAMILY COUNSELING CENTER, INC.
Practice address
925 Hwy V V
Kennett, MO 63857-0071
Phone
(573) 888-5925
Fax
(573) 888-9365
NPI assigned
Jun 16, 2005
Last updated
Jul 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Authorized official

Name
Randy Ray
Title
Ceo
Phone
(573) 888-5925

Specialties & licenses 1

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

Addresses

Primary practice location

925 Hwy V V
Kennett, MO 63857-0071

Mailing address

P.O. Box 71
Kennett, MO 63857
Phone (573) 888-5925

Other identifiers 1

IdentifierTypeStateIssuer
560841504MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040609001127 MO Part B Supplier - Clinic/Group Practice 2163410481 Receives reassigned benefits from 77 practitioners
3 other NPIs on this enrollment
Practice locations: Campbell, MO; West Plains, MO; Wappapello, MO; Van Buren, MO; Poplar Bluff, MO; Piedmont, MO; Mountain Grove, MO; Malden, MO…

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Locations

20 S Sprigg St
Cape Girardeau, MO 63703
Phone (573) 651-4177

910 Truman Blvd
Caruthersville, MO 63830
Phone (573) 333-5202

915 Highway 84 W
Caruthersville, MO 63830
Phone (573) 333-5203

500 State Highway J
Hayti, MO 63851
Phone (573) 359-9840

1109 Jones St
Kennett, MO 63857
Phone (573) 888-6454

875 State Route VV
Kennett, MO 63857
Phone (573) 559-2380

2995 Warrior Ln
Poplar Bluff, MO 63901
Phone (573) 712-2902

1015 Lanton Rd
West Plains, MO 65775
Phone (417) 256-2570

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
FCC Primary Care ClinicKennett, MO, CCN 793851 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 89

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 89

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626739200000",
    "number": "1669477550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 71",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "63857",
            "telephone_number": "573-888-5925",
            "fax_number": "573-888-9365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 HWY V V",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638570071",
            "telephone_number": "573-888-5925",
            "fax_number": "573-888-9365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-888-5925"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "560841504",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennett, MO

Sources for this page

Verify at the official NPI Registry.