Provider Demographics
NPI:1609946433
Name:PHOENIX COUNSELING & CONSULTING SERVICES INC
Entity Type:Organization
Organization Name:PHOENIX COUNSELING & CONSULTING SERVICES INC
Other - Org Name:PHOENIX COUNSELING SERVICES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:410-998-9132
Mailing Address - Street 1:10806 REISTERSTOWN RD
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117
Mailing Address - Country:US
Mailing Address - Phone:410-998-9132
Mailing Address - Fax:410-962-4678
Practice Address - Street 1:10806 REISTERSTOWN RD
Practice Address - Street 2:SUITE 1B
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117
Practice Address - Country:US
Practice Address - Phone:410-998-9132
Practice Address - Fax:410-962-4678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)