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General NPI Number Information
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NPI Number | 1801875653
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Entity Type | Organization
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Legal Business Name | FAMILYWORKS
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Dates
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Enumeration Date | 01/11/2006
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 9856 TONYA CT
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4717
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Country | US
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Telephone | 239-947-0033
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Fax | 239-947-4722
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Provider Business Mailing Address
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Address Line | 9856 TONYA CT
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4717
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Country | US
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Telephone | 239-947-0033
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Fax | 239-947-4722
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Authorized Official
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Title or Position | PRESIDENT
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Name | GERALDINE H MEGEE
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Credential | LCSW
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Telephone | 239-947-0033
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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 | SW1818
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License Number State | FL
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