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General NPI Number Information
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NPI Number | 1225021090
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Entity Type | Organization
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Legal Business Name | FAMILY COUNSELING CENTER, INC.
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1140 THREE RIVERS BLVD
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City | POPLAR BLUFF
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State | MO
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Zip | 63901-3075
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Country | US
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Telephone | 573-686-1200
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Fax | 573-686-1029
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Provider Business Mailing Address
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Address Line | 1140 THREE RIVERS BLVD
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City | POPLAR BLUFF
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State | MO
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Zip | 63901-3075
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Country | US
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Telephone | 573-686-1200
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Fax | 573-686-1029
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Authorized Official
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Title or Position | STAFF PSYCHIATRIST
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Name | DR. MAZHER HUSSAIN
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Credential | M.D.
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Telephone | 573-686-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2002002045
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License Number State | MO
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