Phoenix Social Work Center, Inc.

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Legal business name

PHOENIX SOCIAL WORK CENTER, INC.

Practice address

2200 Lake Ave Ste 240
Fort Wayne, IN 46805-5397

Phone

(260) 424-0411

Fax

(260) 424-3530

NPI assigned

Jun 17, 2024

Last updated

Jun 17, 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

Mr. John W Blanks III

Title

Executive Director

Phone

(260) 424-0411

Specialties & licenses 7

Addresses

Locations

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1518700772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 LAKE AVE STE 240",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055397",
            "telephone_number": "260-424-0411",
            "fax_number": "260-424-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 LAKE AVE STE 240",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055397",
            "telephone_number": "260-424-0411",
            "fax_number": "260-424-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX SOCIAL WORK CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-16",
        "status": "A",
        "authorized_official_last_name": "BLANKS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "260-424-0411",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randall Joseph Phillips, MD
• Rhonda L Phillips, DO
• Robert Arthur Phillips II
• Sheri Lynn Phillips, BSN
• Phoenix Associates Inc.
• Loi K Phuong, MD
• Mary Jennifer Yao Ong Phuong, MD
• Physical Medicine Consultants LLC
• Physical Medicine Consultants LLC
• Physiotherapy Associates

• Case Manager/Care Coordinator in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Case Manager/Care Coordinator in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.