NPIMap

Organization Active NPI

Phoenix Family Center, LLC

  • Adult Mental Health Clinic/Center
  • Elgin, IL
National Provider Identifier
1346736204
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
PHOENIX FAMILY CENTER, LLC
Practice address
452 N McLean Blvd Ste 100
Elgin, IL 60123-3273
Phone
(847) 334-8689
NPI assigned
Jul 3, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Authorized official

Name
Michelle PotterNPI 1053599753
Title
Co-Owner/Therapist
Phone
(224) 535-9555

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

452 N McLean Blvd Ste 100
Elgin, IL 60123-3273

Mailing address

452 N McLean Blvd Ste 100
Elgin, IL 60123-3273
Phone (224) 535-9555

Other practice location 1

474 Summit St
Elgin, IL 60120-3829
Phone (224) 535-3955

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpotter@phoenixfamilycenter.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Family Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

474 Summit St
Elgin, IL 60120
Phone (224) 535-9555

452 N McLean Blvd
Ste 100
Elgin, IL 60123
Phone (847) 334-8689

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1346736204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 N MCLEAN BLVD STE 100",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601233273",
            "telephone_number": "224-535-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 N MCLEAN BLVD STE 100",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601233273",
            "telephone_number": "847-334-8689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "474 Summit St",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601203829",
            "country_code": "US",
            "telephone_number": "224-535-3955",
            "fax_number": "224-241-3183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHOENIX FAMILY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-03",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CO-OWNER/THERAPIST",
        "authorized_official_telephone_number": "224-535-9555"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpotter@phoenixfamilycenter.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "452 N McLean Blvd Ste 100",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601233273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.