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General NPI Number Information
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NPI Number | 1487327938
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Entity Type | Organization
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Legal Business Name | PHOENIX COUNSELING SERVICE, INC.
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Dates
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Enumeration Date | 07/30/2021
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 750 S ORANGE BLOSSOM TRL STE 164
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City | ORLANDO
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State | FL
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Zip | 32805-3162
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Country | US
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Telephone | 352-389-1816
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Fax |
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Provider Business Mailing Address
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Address Line | 7281 SUNSHINE GROVE RD STE 101
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City | BROOKSVILLE
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State | FL
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Zip | 34613-6800
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Country | US
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Telephone | 813-956-5059
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | KEIRA THOMAS
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Credential |
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Telephone | 813-956-5059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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