NPIMap

Organization Active NPI

Family Counseling Center, LLC

  • Clinical Psychologist
  • Fort Wayne, IN
National Provider Identifier
1730480211
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20042458A Issued in IN
Legal business name
FAMILY COUNSELING CENTER, LLC
Practice address
2355 E Cedar Canyons Rd
Fort Wayne, IN 46845-9330
Phone
(260) 925-2017
Fax
(260) 925-9713
NPI assigned
Nov 15, 2010
Last updated
Sep 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Authorized official

Name
Judith L Williams, PSYD HSSPNPI 1508848391
Title
Clinical Psychologist
Phone
(260) 925-2017

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 20042458A IN Primary

Addresses

Primary practice location

2355 E Cedar Canyons Rd
Fort Wayne, IN 46845-9330

Mailing address

PO Box 289
Edgerton, OH 43517-0289
Phone (260) 925-2017

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@familycounselingcenterllc.com

National Provider Directory

National Provider Directory

Locations

347 W 7th St
Auburn, IN 46706
Phone (219) 925-0357

Interoperability endpoints

  • Direct secure messaging: info@familycounselingcenterllc.com

Practitioners & affiliated clinicians

Practitioners 4

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": "1289779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1730480211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 289",
            "city": "EDGERTON",
            "state": "OH",
            "postal_code": "435170289",
            "telephone_number": "260-925-2017",
            "fax_number": "260-925-9713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 E CEDAR CANYONS RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459330",
            "telephone_number": "260-925-2017",
            "fax_number": "260-925-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-15",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "260-925-2017",
        "authorized_official_credential": "PSYD HSSP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042458A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@familycounselingcenterllc.com",
            "affiliation": "N",
            "address_1": "2355 E Cedar Canyons Rd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468459330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.