Phoenix Sobriety

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PHOENIX SOBRIETY

Practice address

1711 Liberty Bell Way Apt 3
Louisville, KY 40215-1671

Phone

(502) 593-6380

NPI assigned

Feb 23, 2024

Last updated

Feb 24, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sachel Joy Elliott

Title

Administration/Officer

Phone

(484) 378-6789

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708732800000",
    "number": "1083470462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 LIBERTY BELL WAY APT 3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151671",
            "telephone_number": "502-593-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 LIBERTY BELL WAY APT 3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151671",
            "telephone_number": "502-593-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX SOBRIETY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-02-24",
        "certification_date": "2024-02-24",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "SACHEL",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "ADMINISTRATION/OFFICER",
        "authorized_official_telephone_number": "484-378-6789"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Louisville, KY by specialty
• Community/Behavioral Health Agency in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2024; 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.