Phoenix Counseling and Recovery LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

PHOENIX COUNSELING AND RECOVERY LLC

Practice address

7949 Brixham Rd
Rockford, IL 61107-2835

Phone

(815) 517-7006

NPI assigned

Mar 17, 2023

Last updated

Mar 17, 2023By 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

Jeffrey Scott Zajkowski, LCPC, CADCNPI 1942674395

Title

Mental Health Therapist

Phone

(815) 517-7006

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey Scott Zajkowski, LPC

  • Professional Counselor
  • Rockford, IL
  • NPI 1942674395
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679011200000",
    "number": "1871295618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7949 BRIXHAM RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611072835",
            "telephone_number": "815-517-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7949 BRIXHAM RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611072835",
            "telephone_number": "815-517-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX COUNSELING AND RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A",
        "authorized_official_last_name": "ZAJKOWSKI",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "815-517-7006",
        "authorized_official_credential": "LCPC, CADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter F Phelan, MD
• Brenden Tyler Phelps
• Jamie E Phelps, ATC
• Jillian Marie Phelps, O.D.
• Ashley Phillips, LCSW
• Phoenix Medical Practice Corporation S C
• Sirivanh Phomvansi Gamez, P.T.
• Physician Associates Limited (D/B/A Cherry Valley Medical Clinic)
• Physicians Care Network, Inc.
• Physicians Immediate Care LTD

• Mental Health Counselor in Rockford, IL
• Providers in Rockford, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.