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General NPI Number Information
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NPI Number | 1407155575
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Entity Type | Organization
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Legal Business Name | FAMILY MATTERS COUNSELING AND CONSULTING LLC
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Dates
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Enumeration Date | 03/15/2011
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Last Update Date | 05/12/2016
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Provider Practice Location Address
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Address Line | 2809 WASHINGTON AVE SUITE R
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City | BEDFORD
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State | IN
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Zip | 47421-5310
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Country | US
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Telephone | 812-278-8707
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Fax |
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Provider Business Mailing Address
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Address Line | 2809 WASHINGTON AVE SUITE R
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City | BEDFORD
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State | IN
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Zip | 47421-5310
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Country | US
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Telephone | 812-278-8707
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Fax | 877-366-6099
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Authorized Official
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Title or Position | OWNER
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Name | JOAN HUNTER GODSEY
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Credential | LCSW
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Telephone | 812-278-8707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34006152A
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License Number State | IN
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