Phoenix Wood, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW019534 Issued in PA

Practice address

525 S 4TH St Ste 598
Philadelphia, PA 19147

Phone

(267) 603-4463

NPI assigned

Jun 4, 2014

Last updated

May 30, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1811300122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 S 4TH ST STE 598",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S 4TH ST STE 598",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19147",
            "telephone_number": "267-603-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "PHOENIX",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-04",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "131460",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW019534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamillah Wood, M.D.
• Kanifah Monyae Wood, LSW
• Kristin Tiedeken Wood, LCSW
• Marcie J Wood, LMFT
• Pamela Lee Wood
• Robert Wood, D.M.D.
• Sarah M Wood, M.D.
• Sarahjane Elizabeth Wood, CRNP
• Steven Wood
• Sulaiman Abdul Aziz Wood, MSS, MLSP

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; 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.