Organization Active NPI

Phoenix Tree Counseling, LLC

  • Clinical Social Worker
  • Lafayette, IN
National Provider Identifier
1184483109
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PHOENIX TREE COUNSELING, LLC
Practice address
100 Executive Dr Ste K
Lafayette, IN 47905-4865
Phone
(317) 938-3141
NPI assigned
Mar 14, 2024
Last updated
Mar 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Authorized official

Name
Tawny Culver, LCSWNPI 1316415003
Title
Partner/Therapist
Phone
(317) 938-3141

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

100 Executive Dr Ste K
Lafayette, IN 47905-4865

Mailing address

1644 E 450 S
Chalmers, IN 47929-8011

National Provider Directory

National Provider Directory

Locations

100 Executive Dr
Ste K
Lafayette, IN 47905
Phone (317) 938-3141

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1184483109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1644 E 450 S",
            "city": "CHALMERS",
            "state": "IN",
            "postal_code": "479298011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EXECUTIVE DR STE K",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054865",
            "telephone_number": "317-938-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX TREE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "CULVER",
        "authorized_official_first_name": "TAWNY",
        "authorized_official_title_or_position": "PARTNER/THERAPIST",
        "authorized_official_telephone_number": "317-938-3141",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.