| 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 |