NPIMap

Organization Active NPI

Family Life Counseling & Psychiatric Services

  • Addiction (Substance Use Disorder) Counselor
  • Mansfield, OH
National Provider Identifier
1669731246
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
FAMILY LIFE COUNSELING & PSYCHIATRIC SERVICES
Practice address
151 Marion Ave
Mansfield, OH 44903-2223
Phone
(419) 774-9969
Fax
(419) 756-5642
NPI assigned
May 16, 2012
Last updated
May 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2012

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

Authorized official

Name
Mr. John Cochran
Title
Cfo
Phone
(419) 774-9969

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU 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
2864575MedicaidOH

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
This NPI is an additional NPI on the 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

10 S Clay St
Ste 104
Millersburg, OH 44654
Phone (330) 275-0573

130 Shady Lane Dr
Bldg D
Norwalk, OH 44857
Phone (567) 743-7199

175 Milan Ave
Norwalk, OH 44857
Phone (419) 602-4083

313 Crestwood Dr
Willard, OH 44890
Phone (567) 560-3586

Practitioners & affiliated clinicians

Practitioners 75

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 75

NPI Registry JSON

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337126400000",
    "number": "1669731246",
    "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": "419-756-5642"
        },
        {
            "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": "419-756-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY LIFE COUNSELING & PSYCHIATRIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-16",
        "last_updated": "2012-05-16",
        "status": "A",
        "authorized_official_last_name": "COCHRAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "419-774-9969",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2864575",
            "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 May 16, 2012; 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.