Phoenix Rising Counseling & Recovery Services

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

070522 Issued in NY

Legal business name

PHOENIX RISING COUNSELING & RECOVERY SERVICES

Practice address

49 Oswego St
Baldwinsville, NY 13027-2448

Phone

(315) 415-9795

NPI assigned

May 13, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Gregg A Heffner, LCSW-R

Title

Psychotherapist/Practice Manager

Phone

(315) 415-9795

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gregg A Heffner, LCSW-R Doing business as

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368403200000",
    "number": "1023454493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 OSWEGO ST",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130272448",
            "telephone_number": "315-415-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 OSWEGO ST",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130272448",
            "telephone_number": "315-415-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RISING COUNSELING & RECOVERY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-13",
        "last_updated": "2013-05-13",
        "status": "A",
        "authorized_official_last_name": "HEFFNER",
        "authorized_official_first_name": "GREGG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST/PRACTICE MANAGER",
        "authorized_official_telephone_number": "315-415-9795",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "070522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01649605",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gregg A Heffner, LCSW-R",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christina Marie Peters, MS-CCC/SLP
• Anthony L Petote, RD
• Mark Joseph Petrie, MA LMFT
• Janet Eileen Petrou
• Phoenix Equestrian Warriors-Rescue-Rehab & Restore Inc.
• Phoenix Rising Counseling & Recovery Services
• Linda Beth Pientka, LPN
• Pinnacle DMX Imaging, LLC
• Podiatry Services of Central New York, PC
• Bettina Polinsky

• Clinical Social Worker in Baldwinsville, NY
• Providers in Baldwinsville, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; 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.