Phoenix Rose Marriage and Family Therapy PLLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

PHOENIX ROSE MARRIAGE AND FAMILY THERAPY PLLC

Practice address

26 Margaret Dr
Roosevelt, NY 11575-1535

Phone

(516) 757-3598

NPI assigned

Apr 27, 2020

Last updated

Apr 27, 2020By 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

Breana D Johnson, LMFTNPI 1114410743

Title

Owner

Phone

(516) 757-3598

Specialties & licenses 1

Addresses

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.

• Breana Johnson, MA,LMFT

  • Marriage & Family Therapist
  • New York, NY
  • NPI 1114410743
  NPD Authorized official

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587945600000",
    "number": "1275154627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 MARGARET DR",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115751535",
            "telephone_number": "516-757-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 MARGARET DR",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115751535",
            "telephone_number": "516-757-3598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX ROSE MARRIAGE AND FAMILY THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BREANA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-757-3598",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billy Ray Parker Jr., LPN
• Charmaine Parker
• Kaitlyn Paul, MS, OTR/L
• Adriana Pereira Fuentes
• Netia Perry
• Donna Picerni
• Crispin Pierre
• Jeoan Pierre
• Kia Monette Pinheiro, NP
• Joshua Pinto

• Marriage & Family Therapist in Roosevelt, NY
• Providers in Roosevelt, NY by specialty
• Marriage & Family Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.