NPIMap

Organization Active NPI

Family Practice & Counseling Services Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
National Provider Identifier
1700678091
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FAMILY PRACTICE & COUNSELING SERVICES NETWORK, INC.
Practice address
4700 Wissahickon Ave Ste 119
Philadelphia, PA 19144-4248
Phone
(267) 597-3600
NPI assigned
May 21, 2025
Last updated
Jul 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Authorized official

Name
Emily Nichols
Title
Ceo
Phone
(267) 597-3604

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

4700 Wissahickon Ave Ste 119
Philadelphia, PA 19144-4248

Mailing address

4700 Wissahickon Ave Ste 118
Philadelphia, PA 19144-4248
Phone (267) 597-3604

Other practice location 1

6501 Limekiln Pike
Philadelphia, PA 19138-3102
Phone (267) 597-3604

Other practice location 2

4101 Freeland Ave
Philadelphia, PA 19128-3509
Phone (267) 597-3604

Other practice location 3

850 N 11th St
Philadelphia, PA 19123-1957
Phone (215) 769-1100

Other practice location 4

1400 W Olney Ave
Philadelphia, PA 19141-2316
Phone (267) 597-3604

Other practice location 5

6120 Woodland Ave
Philadelphia, PA 19142-3200
Phone (215) 727-4721

Other practice location 6

4030 Brown St
Philadelphia, PA 19104-4844
Phone (267) 597-3604

Other practice location 7

2401 S 67th St
Philadelphia, PA 19142-2229
Phone (267) 597-3604

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260427003294 PA Part A Provider - Federally Qualified Health Center (FQHC) 7012424740 Practice locations: Philadelphia, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700678091. Details of each certification follow.

Federally qualified health center certification: CCN D31067

Legal name
FAMILY PRACTICE & COUNSELING SERVICES NETWORK
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 1, 2026
Last certification
May 1, 2026
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
4700 Wissahickon Ave
Ste 118
Philadelphia, PA 19144-4248

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Family Practice Counseling11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

2401 S 67th St
Philadelphia, PA 19142
Phone (215) 400-8100

6120 Woodland Ave
Philadelphia, PA 19142
Phone (215) 727-2765

6501 Limekiln Pike
Philadelphia, PA 19138
Phone (215) 400-7450

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Darrien Johnson Individual Corporate Director Jul 1, 2025
Melissa Gerber Individual Corporate Director Jul 1, 2025
Emily Nichols Individual W-2 Managing EmployeeAd; Jul 1, 2025
Tasha Hannah Individual Corporate Director Sep 24, 2025
Tayanah Scott Individual Corporate Director Sep 24, 2025
Sean McCormick Individual Corporate Director Sep 24, 2025
Elise Cannon Individual Corporate Director Oct 22, 2025
Alia Logan Individual Corporate Director Oct 22, 2025
Ronnessa Edwards Individual Corporate Director Jul 1, 2025
Vera Mosley Individual Corporate Director Oct 22, 2025
Teresa Duncan Individual Corporate Director Jul 1, 2025

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784592000000",
    "number": "1700678091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 WISSAHICKON AVE STE 118",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191444248",
            "telephone_number": "267-597-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WISSAHICKON AVE STE 119",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191444248",
            "telephone_number": "267-597-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6501 Limekiln Pike",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191383102",
            "country_code": "US",
            "telephone_number": "267-597-3604",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4101 Freeland Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191283509",
            "country_code": "US",
            "telephone_number": "267-597-3604",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "850 N 11th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191231957",
            "country_code": "US",
            "telephone_number": "215-769-1100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 W Olney Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191412316",
            "country_code": "US",
            "telephone_number": "267-597-3604",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6120 Woodland Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191423200",
            "country_code": "US",
            "telephone_number": "215-727-4721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4030 Brown St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044844",
            "country_code": "US",
            "telephone_number": "267-597-3604",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2401 S 67th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191422229",
            "country_code": "US",
            "telephone_number": "267-597-3604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAMILY PRACTICE & COUNSELING SERVICES NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-21",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "267-597-3604"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.