NPIMap

Organization Active NPI

Phoenix Counseling Center

  • Community/Behavioral Health Agency
  • Lincolnton, NC
National Provider Identifier
1396845004
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL 036-214 Issued in NC
Legal business name
PHOENIX COUNSELING CENTER
Practice address
322 McBee St
Lincolnton, NC 28092-2819
Phone
(704) 240-9453
Fax
(704) 240-4603
NPI assigned
Sep 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Authorized official

Name
Mr. Kevin Paul Oliver, M.A., MPA
Title
Director
Phone
(704) 491-0829

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X MHL-036-214 NC
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X NC
Case Management Agency 251B00000X MHL 036-214 NC
Community/Behavioral Health Agency 251S00000X MHL 036-214 NC Primary
Community/Behavioral Health Agency 251S00000X
Mental Illness Community Based Residential Treatment Facility 320800000X MHL-036-214 NC
Substance Abuse Rehabilitation Facility 324500000X MHL-036-214 NC

Addresses

Primary practice location

322 McBee St
Lincolnton, NC 28092-2819

Mailing address

839 Majestic CT Ste 1
Gastonia, NC 28054-5152
Phone (704) 396-6747

Other practice location 1

311 McBee St
Lincolnton, NC 28092-2818
Phone (704) 732-0018

Other practice location 2

510 S Aspen St
Lincolnton, NC 28092-2735
Phone (704) 735-7325

Other practice location 3

2505 Court Dr
Gastonia, NC 28054-2140
Phone (704) 861-8014

Other identifiers 6

IdentifierTypeStateIssuer
8301469PMedicaidNC
8301469MedicaidNC
8301469GMedicaidNC
8301469BMedicaidNC
6005727MedicaidNC
8301469QMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120823000785 NC Part B Supplier - Clinic/Group Practice 8426205584 Receives reassigned benefits from 2 practitioners
3 other NPIs on this enrollment
Practice locations: Gastonia, NC; Lincolnton, NC; Shelby, NC

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

839 Majestic Ct
Ste 1
Gastonia, NC 28054
Phone (704) 867-6188

322 McBee St
Lincolnton, NC 28092
Phone (704) 240-9453

631 Brawley School Rd
Ste 407
Mooresville, NC 28117

609 N Washington St
Shelby, NC 28150
Phone (704) 751-3693

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612828800000",
    "number": "1396845004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 MAJESTIC CT STE 1",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545152",
            "telephone_number": "704-396-6747",
            "fax_number": "704-671-2553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 MCBEE ST",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280922819",
            "telephone_number": "704-240-9453",
            "fax_number": "704-240-4603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 McBee St",
            "address_purpose": "LOCATION",
            "city": "Lincolnton",
            "state": "NC",
            "postal_code": "280922818",
            "country_code": "US",
            "telephone_number": "704-732-0018",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "510 S Aspen St",
            "address_purpose": "LOCATION",
            "city": "Lincolnton",
            "state": "NC",
            "postal_code": "280922735",
            "country_code": "US",
            "telephone_number": "704-735-7325",
            "fax_number": "704-735-7370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2505 Court Dr",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280542140",
            "country_code": "US",
            "telephone_number": "704-861-8014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHOENIX COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-23",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-02",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "704-491-0829",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.A., MPA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "MHL-036-214",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": "MHL 036-214",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL 036-214",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-036-214",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NC",
            "license": "MHL-036-214",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301469P",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301469",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301469G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301469B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005727",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301469Q",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincolnton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.