Provider Demographics
NPI:1922691617
Name:PHOENIX THERAPY & WELLNESS, PLLC
Entity Type:Organization
Organization Name:PHOENIX THERAPY & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JULEE
Authorized Official - Middle Name:YOUNG
Authorized Official - Last Name:LLANOS
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHCA
Authorized Official - Phone:845-282-0515
Mailing Address - Street 1:6902 MYRIC CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-6144
Mailing Address - Country:US
Mailing Address - Phone:845-282-0515
Mailing Address - Fax:
Practice Address - Street 1:6902 MYRIC CT
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-6144
Practice Address - Country:US
Practice Address - Phone:845-282-0515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty