Provider Demographics
NPI:1043436207
Name:FAMILY PSYCHOLOGICAL CONSULTANTS
Entity type:Organization
Organization Name:FAMILY PSYCHOLOGICAL CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:WARATUKE
Authorized Official - Suffix:
Authorized Official - Credentials:CREDENTIALING DEPT
Authorized Official - Phone:724-543-1888
Mailing Address - Street 1:365 FRANKLIN HILL RD
Mailing Address - Street 2:RD#8
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201
Mailing Address - Country:US
Mailing Address - Phone:724-543-1888
Mailing Address - Fax:724-543-1899
Practice Address - Street 1:365 FRANKLIN HILL RD
Practice Address - Street 2:RD#8
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-8921
Practice Address - Country:US
Practice Address - Phone:724-543-1888
Practice Address - Fax:724-543-1899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA271657OtherHIGHMARK GROUP NUMBER