NPIMap

Organization Active NPI

Phoenix Counseling and Therapeutic Services, LLC

  • Clinical Social Worker
  • Terrytown, LA
National Provider Identifier
1669928453
Registry record updated Oct 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6795 Issued in LA
Legal business name
PHOENIX COUNSELING AND THERAPEUTIC SERVICES, LLC
Practice address
1720 Stumpf Blvd
202
Terrytown, LA 70056-3997
Phone
(504) 382-9879
Fax
(504) 910-9339
NPI assigned
Aug 31, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2016

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

Authorized official

Name
Mrs. Yettia Benn Jasmine, LCSW
Title
Owner
Phone
(504) 382-9879

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 6795 LA Primary

Addresses

Primary practice location

1720 Stumpf Blvd
202
Terrytown, LA 70056-3997

Mailing address

1221 L B Landry Ave
New Orleans, LA 70114-2656
Phone (504) 382-9879

National Provider Directory

National Provider Directory

Locations

1720 Stumpf Blvd
#202
Terrytown, LA 70056
Phone (504) 382-9879

NPI Registry JSON

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1669928453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 L B LANDRY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701142656",
            "telephone_number": "504-382-9879",
            "fax_number": "504-910-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 STUMPF BLVD",
            "address_2": "202",
            "city": "TERRYTOWN",
            "state": "LA",
            "postal_code": "700563997",
            "telephone_number": "504-382-9879",
            "fax_number": "504-910-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX COUNSELING AND THERAPEUTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "JASMINE",
        "authorized_official_first_name": "YETTIA",
        "authorized_official_middle_name": "BENN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-382-9879",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "6795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terrytown, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; 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.