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Organization

FAMILY & CHILDREN'S CENTER OF COUNSELING AND DEVELOPMENT SERVICES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. PATRICIA HANCOCK LCSW (CLINICAL DIRECTOR)
(574) 232-2255
Entity
Organization

Contact information

Practice address
611 LINCOLNWAY EAST, SOUTH BEND, IN 46601-3220
(574) 232-2255
(574) 232-8968
Mailing address
611 LINCOLNWAY EAST, SOUTH BEND, IN 46601-3220
(574) 232-2255
(574) 232-8968

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103T00000X
Psychologist
Primary
1041C0700X
Clinical Social Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000184548
ANTHEM
IN
05
200264420
IN
01
236961000
MAGELLAN
IN
Enumeration date
10/12/2005
Last updated
10/31/2012
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