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General NPI Number Information
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NPI Number | 1255579983
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Entity Type | Organization
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Legal Business Name | PHASES, LLC
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Dates
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Enumeration Date | 02/03/2009
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 601 BEL AIR BLVD SUITE 404
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City | MOBILE
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State | AL
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Zip | 36606-3513
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Country | US
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Telephone | 251-478-5050
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Fax | 251-478-5015
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Provider Business Mailing Address
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Address Line | 601 BEL AIR BLVD SUITE 404
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City | MOBILE
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State | AL
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Zip | 36606-3513
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Country | US
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Telephone | 251-478-5050
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Fax | 251-478-5015
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Authorized Official
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Title or Position | OWNER
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Name | MS. HELENA F ROLDAN
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Credential | LPC, CADC
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Telephone | 251-478-5050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0832
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2085
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 628
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 163
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License Number State | AL
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Taxonomy #5
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1352
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License Number State | AL
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