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General NPI Number Information
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NPI Number | 1730067091
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Entity Type | Organization
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Legal Business Name | FENIX COUNSELING AND WELLNESS
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 121 WEBB DR
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City | DAVENPORT
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State | FL
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Zip | 33837-3904
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Country | US
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Telephone | 863-313-0172
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Fax |
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Provider Business Mailing Address
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Address Line | 121 WEBB DR
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City | DAVENPORT
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State | FL
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Zip | 33837-3904
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Country | US
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Telephone | 863-313-0172
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | STEFFANY MAGNOLIA MOREL
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Credential | LMHC
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Telephone | 717-379-4952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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