Phoenix Fire ABA

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PHOENIX FIRE ABA

Practice address

456 Pond Apple Rd Unit 37
Clarksville, TN 37043-5357

Phone

(301) 752-6997

Fax

(931) 218-2075

NPI assigned

Nov 17, 2022

Organization subpart

No

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

Authorized official

Name

Fleur Whitehead

Title

Admin Supervisor

Phone

(931) 572-7402

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Jean Parrish, MED.

  • Behavior Analyst
  • Adams, TN
  • NPI 1912495102
  NPD

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1124737283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 POND APPLE RD UNIT 37",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370435357",
            "telephone_number": "301-752-6997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 POND APPLE RD UNIT 37",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370435357",
            "telephone_number": "301-752-6997",
            "fax_number": "931-218-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX FIRE ABA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "WHITEHEAD",
        "authorized_official_first_name": "FLEUR",
        "authorized_official_title_or_position": "ADMIN SUPERVISOR",
        "authorized_official_telephone_number": "931-572-7402"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q052735",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katelynn Phillips, LMT
• Kyla Phillips
• Stevi Phillips, PHARMD
• Allie Philpott, DPT
• Jamia S Phinnessee
• Phoenix Rising Counseling LLC
• Alyssa Janet Pica, CMSW
• Sarah Pichini
• Brittany Pidgeon, DMD
• Jordan Rae Pies, M.A., CCC-SLP

• Community/Behavioral Health Agency in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Community/Behavioral Health Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.