| Phoenix Counseling And Recovery Llc | |
|
7949 Brixham Rd Rockford IL 61107-2835 | |
| (815) 517-7006 | |
| Not Available |
| Full Name | Phoenix Counseling And Recovery Llc |
|---|---|
| Speciality | Counselor |
| Location | 7949 Brixham Rd, Rockford, Illinois |
| Authorized Official Name and Position | Jeffrey Scott Zajkowski (MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 8155177006 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Counseling And Recovery Llc 7949 Brixham Rd Rockford IL 61107-2835 Ph: (815) 517-7006 | Phoenix Counseling And Recovery Llc 7949 Brixham Rd Rockford IL 61107-2835 Ph: (815) 517-7006 |
| NPI Number | 1871295618 |
|---|---|
| Provider Enumeration Date | 03/17/2023 |
| Last Update Date | 03/17/2023 |
| Certification Date | 03/17/2023 |
| Medicare PECOS PAC ID | 0941720858 |
|---|---|
| Medicare Enrollment ID | O20250221003509 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871295618 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jeffrey Scott Zajkowski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942674395 PECOS PAC ID: 1850811761 Enrollment ID: I20250221003537 |
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