Healthcare Provider Details

I. General information

NPI: 1811878283
Provider Name (Legal Business Name): ARLEEN LOUISE PHILLIPS MS EDUCATION
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 ST PATRICK PL
PORT HENRY NY
12974-1200
US

IV. Provider business mailing address

6643 MAIN ST
WESTPORT NY
12993-2005
US

V. Phone/Fax

Practice location:
  • Phone: 518-546-3381
  • Fax: 518-546-7138
Mailing address:
  • Phone: 518-962-4303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number102252071
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: