| Green Phoenix Behavioral Health Services | |
|
3154 Memorial Hwy Ste 100 Dallas PA 18612-9203 | |
| (570) 855-9404 | |
| Not Available |
| Full Name | Green Phoenix Behavioral Health Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 3154 Memorial Hwy Ste 100, Dallas, Pennsylvania |
| Authorized Official Name and Position | Amanda Leah Rodriguez Rogers (OWNER) |
| Authorized Official Contact | 5708559404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Phoenix Behavioral Health Services 2182 State Route 29 Hwy Hunlock Creek PA 18621-4512 Ph: (570) 239-8052 | Green Phoenix Behavioral Health Services 3154 Memorial Hwy Ste 100 Dallas PA 18612-9203 Ph: (570) 855-9404 |
| NPI Number | 1023875010 |
|---|---|
| Provider Enumeration Date | 03/05/2024 |
| Last Update Date | 08/26/2024 |
| Certification Date | 08/26/2024 |
| Medicare PECOS PAC ID | 8921528266 |
|---|---|
| Medicare Enrollment ID | O20250218000447 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023875010 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Amanda Leah Rodriguez Rogers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104606847 PECOS PAC ID: 9830619170 Enrollment ID: I20250218000505 |
Miriam Hartley Lcsw, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1124 Twin Stacks Dr, Dallas, PA 18612 Phone: 570-674-1155 Fax: 570-674-1156 | |
Tara O'donnell Psyd & Associates Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1100 Twin Stacks Dr, Dallas, PA 18612 Phone: 570-855-5369 | |
Cornerstone Counseling & Consulting Specialists Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1172 Twin Stacks Dr, Dallas, PA 18612 Phone: 570-674-1505 Fax: 570-674-8679 | |
Kimberly Pisarcik, Lcsw Therapy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Tarleton Ave, Suite 3, Dallas, PA 18612 Phone: 570-310-1214 Fax: 570-310-1214 | |
Color Tree Consulting Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 17 Reservoir Rd, Dallas, PA 18612 Phone: 570-371-8323 | |
Safe Pathways Counseling Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1172 Twin Stacks Dr, Dallas, PA 18612 Phone: 570-674-1505 Fax: 570-674-8679 |