Phoenix Rising Teen Development

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PHOENIX RISING TEEN DEVELOPMENT

Practice address

2616 Flintridge Dr
Colorado Springs, CO 80918-4425

Phone

(719) 425-5421

NPI assigned

Sep 24, 2024

Last updated

Sep 25, 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 Kathryn Rounsavell, LCSWNPI 1538691548

Title

Ceo / Director

Phone

(719) 648-6092

Specialties & licenses 1

Addresses

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 Rounsavell, LCSW

  • Clinical Social Worker
  • Colorado Springs, CO
  • NPI 1538691548
  NPD Authorized official

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1356168991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2616 FLINTRIDGE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809184425",
            "telephone_number": "719-648-6092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2616 FLINTRIDGE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809184425",
            "telephone_number": "719-425-5421"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1804 Francis Pl",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809092945",
            "country_code": "US",
            "telephone_number": "719-648-6092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHOENIX RISING TEEN DEVELOPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "ROUNSAVELL",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "KATHRYN",
        "authorized_official_title_or_position": "CEO / DIRECTOR",
        "authorized_official_telephone_number": "719-648-6092",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.