Phoenix Rising Counseling & Recovery Services

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R070522 Issued in NY

Legal business name

PHOENIX RISING COUNSELING & RECOVERY SERVICES

Practice address

49 Oswego St
Baldwinsville, NY 13027-2448

Phone

(315) 415-9795

NPI assigned

Oct 7, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Gregg Allen Heffner, LCSW-R

Title

President

Phone

(315) 415-9795

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317945600000",
    "number": "1831473826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 OSWEGO ST",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130272448",
            "telephone_number": "315-415-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 OSWEGO ST",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130272448",
            "telephone_number": "315-415-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RISING COUNSELING & RECOVERY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-07",
        "last_updated": "2011-10-07",
        "status": "A",
        "authorized_official_last_name": "HEFFNER",
        "authorized_official_first_name": "GREGG",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-415-9795",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R070522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony L Petote, RD
• Mark Joseph Petrie, MA LMFT
• Janet Eileen Petrou
• Phoenix Equestrian Warriors-Rescue-Rehab & Restore Inc.
• Phoenix Rising Counseling & Recovery Services
• Linda Beth Pientka, LPN
• Pinnacle DMX Imaging, LLC
• Podiatry Services of Central New York, PC
• Bettina Polinsky
• Michelle T Ponzi, PTA

• Clinical Social Worker in Baldwinsville, NY
• Providers in Baldwinsville, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.