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NPI Code Detail

MEDICARE: FAMILY PRACTICE & COUNSELING SERVICES NETWORK

MEDICARE: FAMILY PRACTICE & COUNSELING SERVICES NETWORK
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
1261QD0000XDental Clinic/Center
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1356335129
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY PRACTICE & COUNSELING SERVICES NETWORK
Provider Business Mailing Address
First Line : 4700 WISSAHICKON AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19144-4248
Country : US
Telephone Number : 215-438-4779
Fax Number : 215-298-0501
Provider Business Practice Location Address
First Line : 850 N 11TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19123-1957
Country : US
Telephone Number : 215-769-1100
Fax Number : 215-769-1117
Authorized Official
Title or Position : CEO
Name : EMILY NICHOLS
Credential :
Telephone Number : 267-597-3604
Provider Enumeration Date : 09/07/2005
Last Update Date : 04/13/2026

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Directions to “FAMILY PRACTICE & COUNSELING SERVICES NETWORK ” Practice Location

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