Amy's Rising Phoenix Counseling, PLLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

AMY'S RISING PHOENIX COUNSELING, PLLC

Practice address

3225 Battleground Ave Ste 4
Greensboro, NC 27408-2636

Phone

(336) 265-2720

Fax

(336) 265-2721

NPI assigned

Jul 24, 2024

Last updated

Jul 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

Mrs. Amy Leigh O'Hearn, LCSW, LCASNPI 1669197976

Title

Owner

Phone

(336) 265-2720

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

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.

• Amy Leigh O'Hearn, MSW, LCAS, LCSW

  • Clinical Social Worker
  • Greensboro, NC
  • NPI 1669197976
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1245068907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 CHADBURY DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274076697",
            "telephone_number": "336-987-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 BATTLEGROUND AVE STE 4",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274082636",
            "telephone_number": "336-265-2720",
            "fax_number": "336-265-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY'S RISING PHOENIX COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "O'HEARN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-265-2720",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW, LCAS"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Adult Mental Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.