PHOENIX THERAPEUTIC FOUNDATION, INC (NPI# 1184983637) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184983637 |
| Entity Type | Organization |
| Organization Name | PHOENIX THERAPEUTIC FOUNDATION, INC |
| Practice Address |
5602 Baltimore National Pike Suite 700 Baltimore MD 21228-1411 |
| Practice Telephone | 4107449100 |
| Practice Fax Number | 4107470226 |
| Mailing Telephone | 4107449100 |
| Mailing Fax Number | 4107470226 |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2012-05-03 |
| Authorized Official Name | AMR A ELBESHIR (CEO) |
| Authorized Official Telephone | 4107449100 |
| Authorized Official Credential | M.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033247945 | Phoenix Therapeutic Foundation, Inc | Counselor | 5602 Baltimore National Pike, Suite 700, Baltimore, MD 21228-1411 | 2007-03-01 |
| Street Address |
5602 BALTIMORE NATIONAL PIKE SUITE 700 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21228-1411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992771265 | Delhi Thweatt Jr. | Specialist | 5602 Baltimore National Pike, 300, Baltimore, MD 21228-1411 | 2006-02-27 |
| 1184031676 | Jena Raymond | Counselor | 5602 Baltimore National Pike, Suite 302b, Baltimore, MD 21228-1411 | 2014-07-16 |
| 1366769184 | Klc Pharmacy | Pharmacy | 5602 Baltimore National Pike, Ste 100, Baltimore, MD 21228-1411 | 2010-05-03 |
| 1235304189 | Thomas M Burggman | Counselor | 5602 Baltimore National Pike, Suite 508, Baltimore, MD 21228-1411 | 2008-04-22 |
| 1992979025 | Heather N Chapman | Social Worker | 5602 Baltimore National Pike, Suite 508, Baltimore, MD 21228-1411 | 2008-04-18 |
| 1336333079 | Phoenix Therapeutic Foundation | Community/Behavioral Health | 5602 Baltimore National Pike, Suburbia Bldg - Suite # 508/6, Baltimore, MD 21228-1411 | 2007-09-05 |
| 1073713970 | Anthony Alberto Campbell | Social Worker | 5602 Baltimore National Pike, Suite # 506, Baltimore, MD 21228-1411 | 2007-07-19 |
| 1023218997 | Delores Ann Mack | Social Worker | 5602 Baltimore National Pike, Suit # 506, Baltimore, MD 21228-1411 | 2007-07-19 |
| 1447474366 | Theresa Marlene Ridley | Social Worker | 5602 Baltimore National Pike, Baltimore, MD 21228 | 2007-04-12 |
| 1265554315 | Horace Greely Ward Jr. | Obstetrics & Gynecology | 5602 Baltimore National Pike, Suite 600, Baltimore, MD 21228-1411 | 2007-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699307975 | Playful Minds | Social Worker | 1009 Frederick Road, Baltimore, MD 21228 | 2020-02-05 |
| 1649818329 | Resolute Medical Care LLC | Nurse Practitioner | 4 E. Rolling Crossroads, Ste 100, Catonsville, MD 21228 | 2019-12-13 |
| 1760020416 | Bh Brightview Rolling Hills Opco, LLC | Alzheimer Center (Dementia Center) | 848 South Rolling Road, Catonsville, MD 21228 | 2019-12-12 |
| 1912542812 | Tiana Green | Counselor | 606 Edmondson Ave., Catonsville, MD 21228 | 2019-11-14 |
| 1699324806 | Maryland Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 4701 Wilkens Ave, Catonsville, MD 21228 | 2019-09-10 |
| 1528613460 | Hyung Joon Kim Dds PC | Dentist | 516 N. Rolling Rd, #201, Catonsville, MD 21228 | 2019-08-07 |
| 1982109658 | William Jones | Counselor | 29 Tentmill Lane, Pikesville, MD 21228 | 2018-03-26 |
| 1740783752 | Jean Walter Infusion Center, LLC | Clinic/Center | 700 Geipe Road St. 100, Catonsville, MD 21228 | 2018-03-15 |
| 1174036578 | Ideal Telemedicine Services, LLC | Clinic/Center | 516 N Rolling Rd Ste 301, Catonsville, MD 21228 | 2017-11-08 |
| 1932627239 | Mind Over Matter Health Services, Inc. | Community/Behavioral Health | 616 Old Edmondson Ave. Ste. 4, Baltimore, MD 21228 | 2017-09-07 |
| Find all providers in zip 21228 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861091522 | Choices Integrated Healthcare | Counselor | 1600 Bush St, Baltimore, MD 21230-2021 | 2020-10-22 |
| 1730791609 | Tony C Shaw | Counselor | 2814 W Garrison Ave, Baltimore, MD 21215-5335 | 2020-08-20 |
| 1023628849 | Delores Jordan | Counselor | 2640 Oswego Ave, Baltimore, MD 21215-7037 | 2020-08-06 |
| 1144838277 | Guiding Lives | Counselor | 6305 Belair Rd, Baltimore, MD 21206-1817 | 2020-07-15 |
| 1750908943 | New Life Services LLC. | Counselor | 3600 W Mulberry St, Baltimore, MD 21229-2928 | 2020-07-03 |
| 1801413422 | Karena Tinika Lee | Counselor | 1336 Homestead St, Baltimore, MD 21218-3624 | 2020-06-30 |
| 1578189668 | Chenelle Gould | Counselor | 4018 Elmora Ave, Baltimore, MD 21213-2120 | 2020-06-24 |
| 1811513625 | Ebony Michelle Johnson | Counselor | 2808 Carver Rd, Baltimore, MD 21225-1312 | 2020-06-18 |
| 1992321798 | Robert Murray | Counselor | 1703 Windemere Ave, Baltimore, MD 21218-3029 | 2020-06-18 |
| 1629694591 | Natale Fiumara | Counselor | 821 N Eutaw St Ste 201, Baltimore, MD 21201-6301 | 2020-06-17 |
| Find all providers in BALTIMORE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.