Healthcare Provider Details

I. General information

NPI: 1245422849
Provider Name (Legal Business Name): FAMILIES FIRST COUNSELING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 11/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24178 FIRST AVENUE, STE 2
SIREN WI
54872-0381
US

IV. Provider business mailing address

PO BOX 381
SIREN WI
54872-0381
US

V. Phone/Fax

Practice location:
  • Phone: 715-349-8913
  • Fax: 715-349-8981
Mailing address:
  • Phone: 715-349-8913
  • Fax: 715-349-8981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2493
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE LYNN HAYMAN
Title or Position: OWNER/ DIRECTOR
Credential: MA/LPC
Phone: 715-349-8913