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General NPI Number Information
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NPI Number | 1922486141
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Entity Type | Organization
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Legal Business Name | FAMILY COUNSELING SERVICE OF NORTHERN NEVADA
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Dates
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Enumeration Date | 05/07/2015
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Last Update Date | 05/08/2015
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Provider Practice Location Address
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Address Line | 575 E PLUMB LN
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City | RENO
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State | NV
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Zip | 89502-3540
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Country | US
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Telephone | 775-329-0623
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Fax | 775-337-2971
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Provider Business Mailing Address
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Address Line | 575 E PLUMB LN
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City | RENO
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State | NV
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Zip | 89502-3540
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Country | US
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Telephone | 775-329-0623
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Fax | 775-337-2971
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. STUART GORDON JR.
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Credential | LCSW, LADC
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Telephone | 775-329-0623
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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 | NV
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