Organization
CAPITOL CITY FAMILY AND EDUCATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRISCILLA SMITH (CHIEF EXECUTIVE OFFICER)
(219) 331-4794
Entity
Organization
Contact information
Practice address
6049 BROADWAY, MERRILLVILLE, IN 46410-2619
(219) 331-4794
(219) 756-1503
Mailing address
6049 BROADWAY, MERRILLVILLE, IN 46410-2619
(219) 331-4794
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
06/05/2012
Last updated
07/21/2022
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