Healthcare Provider Details

I. General information

NPI: 1932665593
Provider Name (Legal Business Name): FAMILY FOUNDATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2019
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1733 BRIARCREST DR STE 205
BRYAN TX
77802-2755
US

IV. Provider business mailing address

PO BOX 5122
BRYAN TX
77805-5122
US

V. Phone/Fax

Practice location:
  • Phone: 817-554-3706
  • Fax: 817-554-3704
Mailing address:
  • Phone: 817-554-3706
  • Fax: 817-554-3704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

Name: WILLIE BERNARD WILLIAMS
Title or Position: PRESIDENT/LICENSED PROFESSIONAL COU
Credential: M.A. LPC
Phone: 817-554-3706