Phoenix Psychotherapy, PLLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

A11260 Issued in NC

Legal business name

PHOENIX PSYCHOTHERAPY, PLLC

Practice address

204 Muirs Chapel Rd
Greensboro, NC 27410-6173

Phone

(336) 645-5507

Fax

(336) 834-0442

NPI assigned

Mar 11, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Ruby Lewis-Dodd, M.A

Title

Psychotherapist

Phone

(336) 645-5507

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1426032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426032000000",
    "number": "1629461959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 MUIRS CHAPEL RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274106173",
            "telephone_number": "336-645-5507",
            "fax_number": "336-834-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 MUIRS CHAPEL RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274106173",
            "telephone_number": "336-645-5507",
            "fax_number": "336-834-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX PSYCHOTHERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-11",
        "last_updated": "2015-03-11",
        "status": "A",
        "authorized_official_last_name": "LEWIS-DODD",
        "authorized_official_first_name": "RUBY",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "336-645-5507",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "A11260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.