NPIMap

Organization Active NPI

Family Service Society Inc

  • Community/Behavioral Health Agency
  • Marion, IN
National Provider Identifier
1780734806
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FAMILY SERVICE SOCIETY INC
Practice address
101 S Washington St
Suite 200
Marion, IN 46952-3867
Phone
(765) 662-9971
Fax
(765) 651-6563
NPI assigned
Jan 11, 2007
Last updated
Jul 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Authorized official

Name
Lisa Dominisse
Title
Ceo
Phone
(765) 662-9971

Specialties & licenses 1

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

Addresses

Primary practice location

101 S Washington St
Suite 200
Marion, IN 46952-3867

Mailing address

101 S Washington St
Suite 200
Marion, IN 46952-3867
Phone (765) 662-9971

Other identifiers 1

IdentifierTypeStateIssuer
100124250MedicaidIN

National Provider Directory

National Provider Directory

Locations

101 S Washington St
Ste 200
Marion, IN 46952
Phone (765) 662-9971

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595894400000",
    "number": "1780734806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S WASHINGTON ST",
            "address_2": "SUITE 200",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469523867",
            "telephone_number": "765-662-9971",
            "fax_number": "765-651-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S WASHINGTON ST",
            "address_2": "SUITE 200",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469523867",
            "telephone_number": "765-662-9971",
            "fax_number": "765-651-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE SOCIETY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A",
        "authorized_official_last_name": "DOMINISSE",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "765-662-9971"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100124250",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.