PHOENIX COUNSELING SERVICES, INC. (NPI# 1396883955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396883955 |
| Entity Type | Organization |
| Organization Name | PHOENIX COUNSELING SERVICES, INC. |
| Practice Address |
729 Charles Seivers Clinton TN 37716 |
| Mailing Address |
Po Box 567 Norris TN 37828-0567 |
| Practice Telephone | 8655487474 |
| Practice Fax Number | 8654949819 |
| Mailing Telephone | 8655487474 |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MIRIAM 'MIMS' GORDON (OWNER, THERAPIST) |
| Authorized Official Telephone | 8655487474 |
| Authorized Official Credential | M.ED., LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
298 | TN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 5441087 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326690595 | Phoenix Counseling Services, Inc. | Counselor | 1820 Central Ave Ste D, Hot Springs, AR 71901-6898 | 2019-07-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | PHOENIX COUNSELING SERVICES, INC. | 425 Park Pl Cir, Ste 150, Mishawaka, IN 46545 |
| Street Address |
729 CHARLES SEIVERS |
| City | CLINTON |
| State | TN |
| Zip Code | 37716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730650870 | Kellye Watkins Wilson | Dental Hygienist | 420 S. Charles Seivers Blvd, Clinton, TN 37716 | 2018-12-16 |
| 1326428087 | Sandra Ella Humphrey Mincey | Registered Nurse | Mcneeley Family Physicians, 110 Executive Park Drive, Clinton, TN 37716 | 2015-06-08 |
| 1598157224 | Susan Price Teffeteller | Nurse Practitioner | 159 Frank L Diggs Road, Clinton, TN 37716 | 2015-03-04 |
| 1710268065 | Jimmy Neil Mcbride | Pharmacist | 1130 North Charles G. Seivers Boulevard, Clinton Drug Store, Clinton, TN 37716 | 2011-08-31 |
| 1265684658 | K-va-t Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 507 South Charles Sevier Boulevard, Clinton, TN 37716 | 2008-10-16 |
| 1912186016 | Comprehensive Industrial Services Inc | Physical Therapist | 1107 Charles Seivers Blvd, Suite 2, Clinton, TN 37716 | 2007-10-25 |
| 1205039120 | Pamela H. Gross, Ph.d, P.C. | Psychologist | 1729 Dutch Valley Road, Clinton, TN 37716 | 2007-06-07 |
| 1396872057 | Health Care Inc | Pharmacy | 1130 N Charles Seivers Blvd, Clinton, TN 37716 | 2007-02-28 |
| 1346389889 | Kellie Gaetz | Physical Therapist | 1115 Charles Seivers Blvd, Suite 22, Clinton, TN 37716 | 2007-02-05 |
| 1831257187 | Kristi George Newton | Dentist | 190 Edgewood Ave, Clinton, TN 37716 | 2006-12-05 |
| Find all providers in zip 37716 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144832882 | Lativia S Brown | Counselor | 9500 Baymar Ct, Clinton, MD 20735-3399 | 2020-08-22 |
| 1013570449 | Jennifer Marie Bartkowiak | Counselor | 2 Williams St Ste 1, Clinton, NY 13323-1748 | 2019-04-22 |
| 1295290609 | Alexis Marie Coleman | Counselor | 205 Shields St, Clinton, NC 28328-3241 | 2019-02-11 |
| 1225592140 | India Alexis Kea | Counselor | 9015 Woodyard Rd Ste 210, Clinton, MD 20735-4209 | 2019-01-24 |
| 1477045995 | Dynamic Psychological & Mediation Services | Counselor | 104 S 7th St, Clinton, OK 73601 | 2018-05-31 |
| 1831688233 | Jed Black | Counselor | 1407 N 2000 W Ste J, Clinton, UT 84015-8563 | 2018-05-02 |
| 1093214116 | Amy Elizabeth Glaser | Counselor | 40 Fairview Ave, Clinton, NJ 08809-1330 | 2018-02-04 |
| 1437662509 | Nancy Anne Baumgartner | Counselor | 65 Old Highway 22 Ste 7b, Clinton, NJ 08809-1315 | 2017-11-13 |
| 1356868236 | Gwendolyn Blake | Counselor | 65 Old Rt. 22, Suite 7b, Clinton, NJ 08809 | 2017-08-23 |
| 1497282743 | Sharon Vessel | Counselor | 10105 Plank Road Suite A, Clinton, LA 70722 | 2017-05-17 |
| Find all providers in CLINTON | ||||
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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.