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General NPI Number Information
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NPI Number | 1770393480
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Entity Type | Organization
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Legal Business Name | FAMILY AND FORENSIC COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 610 ATTLA WAY STE 10
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City | KENAI
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State | AK
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Zip | 99611-7777
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Country | US
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Telephone | 907-252-7460
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1434
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City | SOLDOTNA
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State | AK
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Zip | 99669-1434
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Country | US
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Telephone | 907-252-7460
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTINA GOOLSBY
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Credential | LPC, CDC II, CFMHE
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Telephone | 907-252-7460
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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 |
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License Number State |
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