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General NPI Number Information
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NPI Number | 1699000968
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Entity Type | Organization
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Legal Business Name | CHILDREN AND FAMILY RESOURCES
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Dates
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Enumeration Date | 10/05/2009
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Last Update Date | 10/05/2009
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Provider Practice Location Address
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Address Line | 2135 HANNA ST
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City | FORT WAYNE
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State | IN
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Zip | 46803-2401
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Country | US
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Telephone | 260-452-5509
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Fax |
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Provider Business Mailing Address
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Address Line | 1812 ARDIS ST
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City | FORT WAYNE
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State | IN
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Zip | 46819-1310
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LMHC/CLINICAL DIRECTOR
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Name | MS. JOYCINTH VIVIA JONES
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Credential | MA
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Telephone | 260-478-8073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 39001270A
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License Number State | IN
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