| Phoenix Soaring Counseling LLC | |
|
600 Rodeo Dr # 201 Erlanger KY 41018-1279 | |
| (859) 957-8080 | |
| Not Available |
| Full Name | Phoenix Soaring Counseling LLC |
|---|---|
| Speciality | Social Worker |
| Location | 600 Rodeo Dr # 201, Erlanger, Kentucky |
| Authorized Official Name and Position | Linda Anika Smith (OWNER) |
| Authorized Official Contact | 8593650095 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Soaring Counseling LLC 600 Rodeo Dr # 201 Erlanger KY 41018-1279 Ph: (859) 957-8080 | Phoenix Soaring Counseling LLC 600 Rodeo Dr # 201 Erlanger KY 41018-1279 Ph: (859) 957-8080 |
| NPI Number | 1760170955 |
|---|---|
| Provider Enumeration Date | 04/26/2023 |
| Last Update Date | 12/17/2024 |
| Certification Date | 12/17/2024 |
| Medicare PECOS PAC ID | 2264888395 |
|---|---|
| Medicare Enrollment ID | O20231026001351 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760170955 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | () | Secondary |
| 101YM0800X | Counselor - Mental Health | () | Secondary |
| 1041C0700X | Social Worker - Clinical | () | Primary |
| Provider Name | Linda Anika Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427564350 PECOS PAC ID: 4082060116 Enrollment ID: I20231026001412 |
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