Pheonix Healthcare Consultants, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11477 Issued in FL

Legal business name

PHEONIX HEALTHCARE CONSULTANTS, LLC

Practice address

256 Wallrock CT
Ocoee, FL 34761-4457

Phone

(407) 770-7026

Fax

(407) 703-2721

NPI assigned

Sep 22, 2015

Organization subpart

No

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

Authorized official

Name

Derrick Omar Stephens, LCSW

Title

President and Ceo

Phone

(407) 770-7026

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447632000000",
    "number": "1336518166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 WALLROCK CT",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614457",
            "telephone_number": "407-770-7026",
            "fax_number": "407-703-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 WALLROCK CT",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614457",
            "telephone_number": "407-770-7026",
            "fax_number": "407-703-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHEONIX HEALTHCARE CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-22",
        "last_updated": "2015-11-16",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "OMAR",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "407-770-7026",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "11477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Ocoee, FL
• Providers in Ocoee, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; 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.