NPIMap

Organization Active NPI

Phoenix Counseling Center

  • Addiction (Substance Use Disorder) Counselor
  • Lincolnton, NC
National Provider Identifier
1902074768
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
PHOENIX COUNSELING CENTER
Practice address
510 S Aspen St
Lincolnton, NC 28092-2735
Phone
(704) 735-7719
Fax
(704) 921-3066
NPI assigned
Feb 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Mr. Kevin Paul Oliver, MA, MPA
Title
Executive Director
Phone
(704) 491-0829

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X NC Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Case Management Agency 251B00000X NC
Community/Behavioral Health Agency 251S00000X NC

Addresses

Primary practice location

510 S Aspen St
Lincolnton, NC 28092-2735

Mailing address

631 Brawley School Rd
Suite 200B, PMB 301
Mooresville, NC 28117-6204
Phone (704) 360-4531

Other practice location 1

311 McBee St
Lincolnton, NC 28092-2818
Phone (704) 732-0018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120823000785 NC Part B Supplier - Clinic/Group Practice 8426205584 Receives reassigned benefits from 2 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gastonia, NC; Lincolnton, NC; Shelby, NC

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Counseling Center9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

804 N Lafayette St
Ste 2
Shelby, NC 28150
Phone (704) 476-4106

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1902074768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 BRAWLEY SCHOOL RD",
            "address_2": "SUITE 200B, PMB 301",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281176204",
            "telephone_number": "704-360-4531",
            "fax_number": "704-360-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S ASPEN ST",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280922735",
            "telephone_number": "704-735-7719",
            "fax_number": "704-921-3066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 McBee St",
            "address_purpose": "LOCATION",
            "city": "Lincolnton",
            "state": "NC",
            "postal_code": "280922818",
            "country_code": "US",
            "telephone_number": "704-732-0018",
            "fax_number": "704-240-4603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHOENIX COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-14",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-491-0829",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, MPA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincolnton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.