| Phoenix Counseling And Support Services | |
|
4855 Maccorkle Ave Sw Ste 200 South Charleston WV 25309-1331 | |
| (304) 806-2273 | |
| Not Available |
| Full Name | Phoenix Counseling And Support Services |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 4855 Maccorkle Ave Sw Ste 200, South Charleston, West Virginia |
| Authorized Official Name and Position | Jessica Leigh Halstead (DIRECTOR) |
| Authorized Official Contact | 3048062273 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Counseling And Support Services 4855 Maccorkle Ave Sw Ste 200 South Charleston WV 25309-1331 Ph: (304) 806-2273 | Phoenix Counseling And Support Services 4855 Maccorkle Ave Sw Ste 200 South Charleston WV 25309-1331 Ph: (304) 806-2273 |
| NPI Number | 1285148874 |
|---|---|
| Provider Enumeration Date | 11/20/2017 |
| Last Update Date | 11/20/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285148874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | BP00942576 (West Virginia) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 16-121 (West Virginia) | Primary |
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