Healthcare Provider Details

I. General information

NPI: 1548352743
Provider Name (Legal Business Name): FAMILY CONCERN COUNSELING INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2004 VALPARAISO ST
VALPARAISO IN
46383-3138
US

IV. Provider business mailing address

2004 VALPARAISO ST
VALPARAISO IN
46383-3138
US

V. Phone/Fax

Practice location:
  • Phone: 219-477-5646
  • Fax: 219-728-4765
Mailing address:
  • Phone: 219-477-5646
  • Fax: 219-728-4765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JACKIE VOCKE
Title or Position: BILLING SPECIALIST
Credential:
Phone: 219-301-0228