Rising Phoenix Counseling L.C.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

RISING PHOENIX COUNSELING L.C.

Practice address

1471 Dewar Dr Ste 216
Rock Springs, WY 82901-5826

Phone

(307) 382-0743

Fax

(844) 861-9507

NPI assigned

Jan 4, 2021

Organization subpart

No

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

Authorized official

Name

Tiffani Jean Beatty, LCSW

Title

Director/Owner

Phone

(307) 382-0743

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612828800000",
    "number": "1093303349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1471 DEWAR DR STE 216",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829015826",
            "telephone_number": "307-382-0743",
            "fax_number": "844-861-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1471 DEWAR DR STE 216",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829015826",
            "telephone_number": "307-382-0743",
            "fax_number": "844-861-9507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "389 Douglas Dr",
            "address_purpose": "LOCATION",
            "city": "Rock Springs",
            "state": "WY",
            "postal_code": "829013146",
            "country_code": "US",
            "telephone_number": "307-389-1980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RISING PHOENIX COUNSELING L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A",
        "authorized_official_last_name": "BEATTY",
        "authorized_official_first_name": "TIFFANI",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "307-382-0743",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144270800",
            "state": "WY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "risingphoenix307@gmail.com",
            "affiliation": "N",
            "address_1": "389 Douglas Dr",
            "city": "Rock Springs",
            "state": "WY",
            "country_code": "US",
            "postal_code": "829013146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in Rock Springs, WY
• Providers in Rock Springs, WY by specialty
• Clinical Social Worker in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.