Healthcare Provider Details
I. General information
NPI: 1477573079
Provider Name (Legal Business Name): THE FAMILY INSTITUTE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/20/2006
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 STATE ST SUITE 202
ERIE PA
16507-1453
US
IV. Provider business mailing address
100 STATE ST SUITE 202
ERIE PA
16507-1453
US
V. Phone/Fax
- Phone: 814-480-8797
- Fax: 814-459-2303
- Phone: 814-480-8797
- Fax: 814-459-2303
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TP2701X |
| Taxonomy | Group Psychotherapy Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DOMENICO
CHIARIELLO
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 814-480-8797