Wendi Ellen Phoenix

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

72824 Issued in TX

Practice address

1345 River Bend Dr
Dallas, TX 75247-6943

Phone

(214) 743-1200

NPI assigned

Oct 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cedar Creek Wellness Group

  • Psychiatric/Mental Health Nurse Practitioner
  • Gun Barrel City, TX
  • NPI 1922648310
  NPD

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1396387445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 W MAIN ST",
            "city": "GUN BARREL CITY",
            "state": "TX",
            "postal_code": "751564401",
            "telephone_number": "903-910-2294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 RIVER BEND DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752476943",
            "telephone_number": "214-743-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHOENIX",
        "first_name": "WENDI",
        "middle_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "72824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoenix Chiropractic Dallas
• Phoenix Houses of Texas, Inc
• Phoenix Pain Clinic, PLLC
• Phoenix Thera-Lase Systems, LLC.
• Jill Annette Phoenix, CRNA
• Cindy Phok
• Claire Phoneprasert
• PHR Diagnostics, LLC
• Jennifer Tracy Phu, DDS
• Tri Minh Phung, MD

• Professional Counselor in Dallas, TX
• Providers in Dallas, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.