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General NPI Number Information
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NPI Number | 1851448633
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL AND FAMILY CONSULTANTS INC
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 08/20/2012
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Provider Practice Location Address
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Address Line | 1254 OCALA RD
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City | TALLAHASSEE
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State | FL
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Zip | 32304-1548
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Country | US
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Telephone | 850-575-8954
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Fax | 850-575-9445
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Provider Business Mailing Address
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Address Line | 1254 OCALA RD
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City | TALLAHASSEE
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State | FL
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Zip | 32304-1548
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Country | US
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Telephone | 850-575-8954
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Fax | 850-575-9445
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Authorized Official
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Title or Position | PSYCHOLOGIST PRESIDENT OF CORP.
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Name | DR. CHARLES H MADSEN
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Credential | PHD
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Telephone | 850-575-8954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY 2886
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License Number State | FL
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