Phoenix Healing, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PHOENIX HEALING, LLC

Practice address

45 S Main St Ste 107
West Hartford, CT 06107-2402

Phone

(860) 352-0813

NPI assigned

Oct 9, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kristina Baker, LCSW

Title

Psychotherapist

Phone

(860) 463-9684

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570579200000",
    "number": "1003458316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 S MAIN ST STE 107",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 S MAIN ST STE 107",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072402",
            "telephone_number": "860-352-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HEALING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-09",
        "last_updated": "2019-10-09",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "860-463-9684",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Philip, D.O.
• Meghan Philips, APRN
• Cruger Johnson Phillips, L.P.C.
• Doris J Phillips, MD
• Janna Marie Phillips, L.C.S.W.
• Tanesha S Pickard
• Pieces to Peace Clinical Initiatives, Inc
• Alyssa Pierre-Louis, LCSW
• Kimberly Lynn Pikor, LMSW
• Lisa Pillow, M.S.,CCC-SLP

• Community/Behavioral Health Agency in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Community/Behavioral Health Agency in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.