Provider Demographics
NPI:1245564285
Name:PHOENIX THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:PHOENIX THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROMANELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-387-2455
Mailing Address - Street 1:51 BRACKEN PL
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15239-2548
Mailing Address - Country:US
Mailing Address - Phone:724-387-2455
Mailing Address - Fax:724-387-2456
Practice Address - Street 1:51 BRACKEN PL
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15239-2548
Practice Address - Country:US
Practice Address - Phone:724-387-2455
Practice Address - Fax:724-387-2456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty