MEDICARE: FAMILY CARE ASSOCIATES

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	103T00000X	Psychologist
3	163WP0808X	Psychiatric/Mental Health Registered Nurse
4	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1780269266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CARE ASSOCIATES

Provider Business Mailing Address
First Line	:	702 RUSSELL AVE STE 100
Second Line	:
City	:	GAITHERSBURG
State	:	MD
Zip	:	20877-2605
Country	:	US
Telephone Number	:	301-330-0006
Fax Number	:

Provider Business Practice Location Address
First Line	:	3508 WORTHINGTON BLVD UNIT 101
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21704-7077
Country	:	US
Telephone Number	:	301-330-0006
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL BILLING MANAGER
Name	:	EUNICE HE
Credential	:
Telephone Number	:	301-330-0006

Provider Enumeration Date	:	03/16/2021
Last Update Date	:	03/16/2021

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Directions to “FAMILY CARE ASSOCIATES ” Practice Location

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