Phoenix Rising Life Coaching Services, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PHOENIX RISING LIFE COACHING SERVICES, LLC

Doing business as

Phoenix Rising Counseling and Life Coaching Services

Practice address

35 E Elizabeth Ave Ste 6
Bethlehem, PA 18018-6505

Phone

(610) 442-7186

NPI assigned

Jan 10, 2020

Organization subpart

No

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

Authorized official

Name

Simone Cidnee Allison Phillips, MSW, LCSW, BA, RNNPI 1003371881

Title

Practice Owner/Ceo

Phone

(484) 895-5915

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PHOENIX RISING COUNSELING AND LIFE COACHING SERVICES Doing business as

Locations

Practitioners 1

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

• Simone Cidnee-Allison Phillips, LCSW

  • Clinical Social Worker
  • NPI 1003371881
  NPD Authorized official

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593129600000",
    "number": "1144860727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 E ELIZABETH AVE STE 6",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180186505",
            "telephone_number": "610-442-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 E ELIZABETH AVE STE 6",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180186505",
            "telephone_number": "610-442-7186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RISING LIFE COACHING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "SIMONE",
        "authorized_official_middle_name": "CIDNEE ALLISON",
        "authorized_official_title_or_position": "PRACTICE OWNER/CEO",
        "authorized_official_telephone_number": "484-895-5915",
        "authorized_official_credential": "MSW, LCSW, BA, RN"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOT APPLICABLE",
            "identifier": "1144860727",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHOENIX RISING COUNSELING AND LIFE COACHING SERVICES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PHOENIX RISING COUNSELING AND LIFE COACHING SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Debra E Phillips, PTA
• Hayden Reese Phillips III, PA-C
• Heather L Phillips, PSY.D.
• James Evan Phillips, D.O.
• Lynn Phillips, FNP
• Phoenix Services, Inc.
• Physicians Medical Weight Loss, LLC
• Jorge S Picado, PA-C
• Jasmine Pickard
• Diane Volpe Pickett, LCSW

• Mental Health Clinic/Center (Including Community Mental Health Center) in Bethlehem, PA
• Providers in Bethlehem, PA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; 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.