MEDICARE: FAMILY COUNSELING CENTER, 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	101YM0800X	Mental Health Counselor	#MH3149	FL
2	101YP1600X	Pastoral Counselor
3	1041C0700X	Clinical Social Worker	#SW8140	FL
4	101YM0800X	Mental Health Counselor	#MH4135	FL

General Provider Information

NPI Number	:	1568525574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY COUNSELING CENTER, INC.

Provider Business Mailing Address
First Line	:	439 CORTEZ RD W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34207-1544
Country	:	US
Telephone Number	:	941-755-7830
Fax Number	:	941-755-5650

Provider Business Practice Location Address
First Line	:	439 CORTEZ RD W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34207-1544
Country	:	US
Telephone Number	:	941-755-7830
Fax Number	:	941-755-5650

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	MS. LINDA MAURINE MARTIN
Credential	:	MS, CFM, LMHC
Telephone Number	:	941-755-7830

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	09/11/2025

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