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General NPI Number Information
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NPI Number | 1639594195
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Entity Type | Organization
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Legal Business Name | FAUCETTE CHILD & FAMILY COUNSELING
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Dates
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Enumeration Date | 02/20/2014
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Last Update Date | 02/20/2014
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Provider Practice Location Address
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Address Line | 3212 MAHONING AVE SUITE 4
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City | YOUNGSTOWN
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State | OH
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Zip | 44509-2600
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Country | US
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Telephone | 330-318-3436
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Fax | 330-319-8800
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Provider Business Mailing Address
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Address Line | 3212 MAHONING AVE SUITE 4
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City | YOUNGSTOWN
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State | OH
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Zip | 44509
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Country | US
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Telephone | 330-318-3436
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Fax | 330-319-8800
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | CAROLYN FAUCETTE
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Credential | MSW, LISW-S, LBS
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Telephone | 330-318-3436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | BH001192
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | I0900303
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License Number State | OH
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