MEDICARE: FAMILY OPTIONS COUNSELING

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor
3	103T00000X	Psychologist
4	1041C0700X	Clinical Social Worker
5	251S00000X	Community/Behavioral Health Agency
6	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1437322807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY OPTIONS COUNSELING

Provider Business Mailing Address
First Line	:	3505 N 124TH ST
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53005-2489
Country	:	US
Telephone Number	:	414-431-4444
Fax Number	:	414-431-0858

Provider Business Practice Location Address
First Line	:	3505 N 124TH ST
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53005-2489
Country	:	US
Telephone Number	:	414-431-4444
Fax Number	:	414-431-0858

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. CHRISTY DIORIO
Credential	:	PH.D
Telephone Number	:	414-431-4444

Provider Enumeration Date	:	04/08/2008
Last Update Date	:	10/07/2022

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