Organization
FAMILY SERVICE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP JOSEPH DELUCA MSW (DIRECTOR)
(704) 864-7704
Entity
Organization
Contact information
Practice address
214 E. FRANKLIN BLVD, GASTONIA, NC 28052
(704) 864-7704
(704) 862-0239
Mailing address
214 E. FRANKLIN BLVD, GASTONIA, NC 28052
(704) 864-7704
(704) 862-0239
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
3588
NC
101Y00000X
Counselor
3726
NC
101Y00000X
Counselor
6682
NC
101Y00000X
Counselor
Primary
C000132
NC
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0242M
BLUE CROSS/BLUE SHIELD
NC
05
—
6003807
—
NC
Enumeration date
05/17/2006
Last updated
12/16/2008
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