MEDICARE: FAMILY COUNSELING ASSOCIATES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	4347	FL
2	1041C0700X	Clinical Social Worker	4786	FL
3	1041C0700X	Clinical Social Worker	SW 4901	FL
4	1041C0700X	Clinical Social Worker	SW 5367	FL
5	1041C0700X	Clinical Social Worker	SW 6254	FL
6	1041C0700X	Clinical Social Worker	SW5740	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z071W	OTHER	FL	MELISSA FEIN, LCSW BCBS#
2	Z8250	OTHER	FL	JULIE AKERS, LCSW BCBS #
3	Z013L	OTHER	FL	H KENDRIGAN,LCSW BCBS#
4	Z7718	OTHER	FL	GAIL GUILLORY, LCSW BCBS#
5	Z087N	OTHER	FL	ELISA FRALEY, LCSW BCBS #
6	Z120N	OTHER	FL	N STEINFELD, LCSW BCBS#
7	Z121J	OTHER	FL	BCBSFL PA GROUP #
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023140381
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY COUNSELING ASSOCIATES INC

Provider Business Mailing Address
First Line	:	4425 MILITARY TRAIL
Second Line	:	STE 203
City	:	JUPITER
State	:	FL
Zip	:	33458-4817
Country	:	US
Telephone Number	:	561-747-2775
Fax Number	:	561-747-1881

Provider Business Practice Location Address
First Line	:	4425 MILITARY TRAIL
Second Line	:	SUITE 203
City	:	JUPITER
State	:	FL
Zip	:	33458-4817
Country	:	US
Telephone Number	:	561-747-2775
Fax Number	:	561-747-1881

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. GAIL DIANE GUILLORY
Credential	:	LCSW
Telephone Number	:	561-747-2775

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	07/30/2008

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