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NPI Code Detail

MEDICARE: MRS. KENZY PHILLIPS

MEDICARE: MRS. KENZY PHILLIPS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1093504664
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KENZY PHILLIPS
Provider Business Mailing Address
First Line : 15 PARKWOOD DR
Second Line :
City : COVINGTON
State : GA
Zip : 30016-8514
Country : US
Telephone Number : 678-906-1374
Fax Number :
Provider Business Practice Location Address
First Line : 50 LENOX POINTE NE STE A
Second Line :
City : ATLANTA
State : GA
Zip : 30324-3103
Country : US
Telephone Number : 678-824-6590
Fax Number : 678-228-1258
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2025
Last Update Date : 05/01/2025

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Directions to “ MRS. KENZY PHILLIPS ” Practice Location

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