MEDICARE: PHOENIX COUNSELING SERVICE, INC.

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
1	251B00000X	Case Management Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538811435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHOENIX COUNSELING SERVICE, INC.

Provider Business Mailing Address
First Line	:	7281 SUNSHINE GROVE RD STE 101
Second Line	:
City	:	BROOKSVILLE
State	:	FL
Zip	:	34613-6800
Country	:	US
Telephone Number	:	352-389-1816
Fax Number	:	352-389-1119

Provider Business Practice Location Address
First Line	:	8909 REGENTS PARK DR STE 420
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3432
Country	:	US
Telephone Number	:	352-389-1816
Fax Number	:	352-389-1119

Authorized Official
Title or Position	:	CFO
Name	:	KEIRA THOMAS
Credential	:
Telephone Number	:	813-956-5059

Provider Enumeration Date	:	01/21/2022
Last Update Date	:	02/06/2025

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Directions to “PHOENIX COUNSELING SERVICE, INC. ” Practice Location

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