| Phoenix Psychological & Counseling Assoc Inc | |
| Rt 20 Quiet Dell WV 26408 | |
| (304) 622-6404 | |
| (304) 622-6404 | 
| Full Name | Phoenix Psychological & Counseling Assoc Inc | 
|---|---|
| Speciality | Counselor | 
| Location | Rt 20, Quiet Dell, West Virginia | 
| Authorized Official Name and Position | Charles Mcclure Green (OWNER) | 
| Authorized Official Contact | 3046226404 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Phoenix Psychological & Counseling Assoc Inc 4579 Buckhannon Pike Ste 101 Mount Clare WV 26408-7176 Ph: (304) 622-6404 | Phoenix Psychological & Counseling Assoc Inc Rt 20 Quiet Dell WV 26408 Ph: (304) 622-6404 | 
| NPI Number | 1386631786 | 
|---|---|
| Provider Enumeration Date | 09/30/2005 | 
| Last Update Date | 07/21/2022 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1386631786 | NPI | - | NPPES | 
| 001710319 | Other | WV | BCBS | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 103T00000X | Psychologist | (West Virginia) | Secondary | 
| 1041C0700X | Social Worker - Clinical | (West Virginia) | Secondary | 
| 101Y00000X | Counselor | (West Virginia) | Primary |