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General NPI Number Information
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NPI Number | 1649830530
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Entity Type | Organization
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Legal Business Name | THE FAMILY MINISTRY COUNSELING AND PSYCOTHERAPY SERVICE
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Dates
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Enumeration Date | 06/13/2019
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Last Update Date | 06/13/2019
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Provider Practice Location Address
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Address Line | 700 E JEFFERSON ST STE 245
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City | PHOENIX
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State | AZ
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Zip | 85034-2204
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Country | US
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Telephone | 602-616-4433
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Fax | 602-283-4021
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Provider Business Mailing Address
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Address Line | 700 E JEFFERSON ST STE 245
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City | PHOENIX
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State | AZ
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Zip | 85034-2204
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Country | US
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Telephone | 602-616-4433
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Fax | 602-283-4021
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. THOMAS J LEWIS
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Credential | LMFT
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Telephone | 602-283-4524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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