Healthcare Provider Details

I. General information

NPI: 1124363072
Provider Name (Legal Business Name): FAMILY AND MEDICAL COUNSELING SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2012
Last Update Date: 10/13/2020
Certification Date: 10/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 MARTIN LUTHER KING JR AVE SE SUITE 303
WASHINGTON DC
20020
US

IV. Provider business mailing address

2041 MARTIN LUTHER KING JR AVE SE SUITE 303
WASHINGTON DC
20020-7024
US

V. Phone/Fax

Practice location:
  • Phone: 202-889-7900
  • Fax: 202-610-3095
Mailing address:
  • Phone: 202-889-7900
  • Fax: 202-610-3095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License NumberH80CS24175
License Number StateDC

VIII. Authorized Official

Name: DR. FLORA TERRELL HAMILTON
Title or Position: CEO
Credential: LICSW
Phone: 202-889-7900