MEDICARE: FAMILY SUCCESS CONSORTIUM INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	4512	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275724916
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY SUCCESS CONSORTIUM INC

Provider Business Mailing Address
First Line	:	11497 SPRINGFIELD PIKE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45246-3551
Country	:	US
Telephone Number	:	513-772-9300
Fax Number	:	513-772-9302

Provider Business Practice Location Address
First Line	:	11497 SPRINGFIELD PIKE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45246-3551
Country	:	US
Telephone Number	:	513-772-9300
Fax Number	:	513-772-9302

Authorized Official
Title or Position	:	PSYCHOLOGIST/PRESIDENT
Name	:	DR. MARK KENDAL EVANS
Credential	:	PSY.D.
Telephone Number	:	513-772-9300

Provider Enumeration Date	:	08/07/2007
Last Update Date	:	06/23/2010

Similar Medicare Providers

1023954369 — TARGET HEALTH CARE LLC
Practice Location Address:

11497 SPRINGFIELD PIKE STE 7
CINCINNATI, OH
45246-3551

Practice Phone: 513-426-8492
Practice Fax: 513-426-8641

1770687055 — DR. DONALD HENRY MALNOFSKI DDS
Practice Location Address:

11497 SPRINGFIELD PIKE , SUITE 2
CINCINNATI, OH
45246-3551

Practice Phone: 513-772-2396
Practice Fax: 513-772-2399

1942333950 — DR. GREGORY WNEK DDS
Practice Location Address:

11497 SPRINGFIELD PIKE STE 3
CINCINNATI, OH
45246-3551

Practice Phone: 513-771-0844
Practice Fax: 513-771-0844

1780808741 — DR. JOHN MARTIN TIDD PSY.D.
Practice Location Address:

11497 SPRINGFIELD PIKE
CINCINNATI, OH
45246-3551

Practice Phone: 513-772-9300
Practice Fax: 513-772-9302

1790901262 — DR. WILLIAM LEE CAHALAN PH.D.
Practice Location Address:

11497 SPRINGFIELD PIKE
CINCINNATI, OH
45246-3551

Practice Phone: 513-772-9300
Practice Fax: 513-772-9302

1386960391 — DR. ANGELA LYNN VREDEVELD PSYD
Practice Location Address:

11497 SPRINGFIELD PIKE , SUITE 5
CINCINNATI, OH
45246-3551

Practice Phone: 513-772-9300
Practice Fax:

Directions to “FAMILY SUCCESS CONSORTIUM INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.