Phoenix Therapeutic Services, Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW14849 Issued in FL

Legal business name

PHOENIX THERAPEUTIC SERVICES, INC

Practice address

12245 Gehrig Dr
Jacksonville, FL 32224-4630

Phone

(904) 662-0126

NPI assigned

Mar 7, 2018

Organization subpart

No

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

Authorized official

Name

Lindsey Dawn Chapman, LCSW

Title

Owner

Phone

(904) 662-0126

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565308800000",
    "number": "1336641265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12245 GEHRIG DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322244630",
            "telephone_number": "904-662-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12245 GEHRIG DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322244630",
            "telephone_number": "904-662-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX THERAPEUTIC SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-07",
        "last_updated": "2019-08-09",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-662-0126",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW14849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoenix Behavioral Health Services, Inc.
• Phoenix CM Inc.
• Phoenix Healthcare Properties of Mandarin, LLC (Southlake Nursing and Rehabilitation Center)
• Phoenix Rising Solutions Inc
• Phoenix Rising Wellness & Counseling
• Ava E Phoenix, M.D.
• Davong David Phrathep, DO
• Hong Phung
• Lauren Phung, MD
• Phuong Lu DO PA

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, 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 Aug 9, 2019; 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.