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General NPI Number Information
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NPI Number | 1700678091
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Entity Type | Organization
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Legal Business Name | FAMILY PRACTICE & COUNSELING SERVICES NETWORK
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Dates
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Enumeration Date | 05/21/2025
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Last Update Date | 04/13/2026
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Provider Practice Location Address
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Address Line | 4700 WISSAHICKON AVE STE 119
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City | PHILADELPHIA
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State | PA
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Zip | 19144-4248
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Country | US
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Telephone | 267-597-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 4700 WISSAHICKON AVE STE 118
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City | PHILADELPHIA
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State | PA
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Zip | 19144-4248
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Country | US
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Telephone | 267-597-3604
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | EMILY NICHOLS
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Credential |
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Telephone | 267-597-3604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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