| Phoenix Counseling Center | |
|
322 Mcbee St Lincolnton NC 28092-2819 | |
| (704) 240-9453 | |
| (704) 240-4603 |
| Full Name | Phoenix Counseling Center |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 322 Mcbee St, Lincolnton, North Carolina |
| Authorized Official Name and Position | Kevin Paul Oliver (DIRECTOR) |
| Authorized Official Contact | 7044910829 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Counseling Center 839 Majestic Ct Ste 1 Gastonia NC 28054-5152 Ph: (704) 396-6747 | Phoenix Counseling Center 322 Mcbee St Lincolnton NC 28092-2819 Ph: (704) 240-9453 |
| NPI Number | 1396845004 |
|---|---|
| Provider Enumeration Date | 09/23/2006 |
| Last Update Date | 02/09/2021 |
| Certification Date | 02/02/2021 |
| Medicare PECOS PAC ID | 8426205584 |
|---|---|
| Medicare Enrollment ID | O20120823000785 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396845004 | NPI | - | NPPES |
| 8301469P | Medicaid | NC | |
| 8301469 | Medicaid | NC | |
| 8301469G | Medicaid | NC | |
| 8301469B | Medicaid | NC | |
| 6005727 | Medicaid | NC | |
| 8301469Q | Medicaid | NC |
| Provider Name | Nilima V Shukla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922189877 PECOS PAC ID: 2961505003 Enrollment ID: I20070906000770 |
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