Healthcare Provider Details

I. General information

NPI: 1205875127
Provider Name (Legal Business Name): FAMILY FOCUS COUNSELING SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20B JOHN MARSHALL ST
WARRENTON VA
20186-3214
US

IV. Provider business mailing address

20B JOHN MARSHALL ST
WARRENTON VA
20186-3214
US

V. Phone/Fax

Practice location:
  • Phone: 540-349-4537
  • Fax: 540-349-2369
Mailing address:
  • Phone: 540-349-4537
  • Fax: 540-349-2369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0904000285
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0904000285
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904000285
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0904000285
License Number StateVA

VIII. Authorized Official

Name: MR. JOHN D BORGENS
Title or Position: DIRECTOR/OWNER
Credential: LCSW
Phone: 540-349-4537