Provider Demographics
NPI:1346632429
Name:PHOENIX THERAPY SERVICES
Entity Type:Organization
Organization Name:PHOENIX THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOWE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:517-803-7599
Mailing Address - Street 1:45449 GALWAY DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-3917
Mailing Address - Country:US
Mailing Address - Phone:517-803-7599
Mailing Address - Fax:888-690-5429
Practice Address - Street 1:45449 GALWAY DR
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-3917
Practice Address - Country:US
Practice Address - Phone:151-780-3759
Practice Address - Fax:888-690-5462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-25
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013635103T00000X
MI68010894401041C0700X
MI68010796311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty