MEDICARE: PHOENIX PARTNERS NC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1598363780
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHOENIX PARTNERS NC

Provider Business Mailing Address
First Line	:	7621 PURFOY RD STE 210
Second Line	:
City	:	FUQUAY VARINA
State	:	NC
Zip	:	27526-6985
Country	:	US
Telephone Number	:	919-480-0101
Fax Number	:	919-205-9919

Provider Business Practice Location Address
First Line	:	7621 PURFOY RD STE 210
Second Line	:
City	:	FUQUAY VARINA
State	:	NC
Zip	:	27526-6985
Country	:	US
Telephone Number	:	833-749-4584
Fax Number	:	919-205-9919

Authorized Official
Title or Position	:	FOUNDING THERAPIST
Name	:	ALICIA PETON
Credential	:	LCMHC, LCAS
Telephone Number	:	919-480-0101

Provider Enumeration Date	:	10/11/2020
Last Update Date	:	12/16/2025

Similar Medicare Providers

1205523131 — DR. LANA SAMPSON MS, PH.D.
Practice Location Address:

7621 PURFOY RD STE 210
FUQUAY VARINA, NC
27526-6985

Practice Phone: 919-637-6867
Practice Fax: 919-205-9919

1669283388 — ASHLEY MILLER LCMHCA
Practice Location Address:

7621 PURFOY RD STE 210
FUQUAY VARINA, NC
27526-6985

Practice Phone: 607-422-4770
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1194041962 — MS. ALICIA IVANA PETON M.S., LCMHC
Practice Location Address:

7621 PURFOY RD STE 210
FUQUAY VARINA, NC
27526-6985

Practice Phone: 919-523-2100
Practice Fax: 919-205-9919

1447007570 — JENNIFER DIANNE CONRAD
Practice Location Address:

7621 PURFOY RD STE 105B
FUQUAY VARINA, NC
27526-6985

Practice Phone: 833-749-4584
Practice Fax:

1356181994 — JESSE PARRISH
Practice Location Address:

7621 PURFOY RD
FUQUAY VARINA, NC
27526-6985

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Practice Fax:

1184459158 — NICOLE SARGENT LCSWA
Practice Location Address:

7621 PURFOY RD STE 201
FUQUAY VARINA, NC
27526-6985

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Directions to “PHOENIX PARTNERS NC ” Practice Location

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